Provider Demographics
NPI:1447312608
Name:ACOSTA, DANIELLE MONIQUE
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MONIQUE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:M
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4125 HINSDALE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2703
Mailing Address - Country:US
Mailing Address - Phone:216-926-4565
Mailing Address - Fax:
Practice Address - Street 1:4125 HINSDALE RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2703
Practice Address - Country:US
Practice Address - Phone:216-926-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program