Provider Demographics
NPI:1760098271
Name:SPEARS, DANIELLE (PSY D)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SPEARS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MORTIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1340 PRUDENTIAL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-4115
Mailing Address - Country:US
Mailing Address - Phone:813-203-6100
Mailing Address - Fax:
Practice Address - Street 1:1340 PRUDENTIAL DR STE A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-4115
Practice Address - Country:US
Practice Address - Phone:214-631-9270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-20
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist