Provider Demographics
NPI:1588338669
Name:MARSHALL-CLEMONS, DANESA DANIELLE (BSW)
Entity type:Individual
Prefix:
First Name:DANESA
Middle Name:DANIELLE
Last Name:MARSHALL-CLEMONS
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 EDALBERT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-7695
Mailing Address - Country:US
Mailing Address - Phone:513-741-3100
Mailing Address - Fax:513-741-5686
Practice Address - Street 1:6680 POE AVE STE 450
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2857
Practice Address - Country:US
Practice Address - Phone:513-741-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator