Provider Demographics
NPI:1992440499
Name:PALMER, DANIELLE (MS)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6590 STONEGATE DR
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47022-9753
Mailing Address - Country:US
Mailing Address - Phone:812-655-3058
Mailing Address - Fax:
Practice Address - Street 1:7310 TURFWAY RD STE 550
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4872
Practice Address - Country:US
Practice Address - Phone:812-655-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801054101YM0800X
KY240454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health