Provider Demographics
NPI:1447063136
Name:MOLLER-THAU, DANIELLE CATE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:CATE
Last Name:MOLLER-THAU
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:MOLLER
Other - Last Name:THAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:666 GLENBROOK RD STE 2C
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-1439
Mailing Address - Country:US
Mailing Address - Phone:203-536-4636
Mailing Address - Fax:
Practice Address - Street 1:666 GLENBROOK RD STE 2C
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-1439
Practice Address - Country:US
Practice Address - Phone:203-323-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002387103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty