Provider Demographics
NPI:1962980615
Name:RESECK, DANIELLE HAYES
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:HAYES
Last Name:RESECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 MARILYN DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-0617
Mailing Address - Country:US
Mailing Address - Phone:405-834-8073
Mailing Address - Fax:
Practice Address - Street 1:4149 HIGHLINE BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-2103
Practice Address - Country:US
Practice Address - Phone:405-942-7650
Practice Address - Fax:405-942-7686
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-04
Last Update Date:2018-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program