Southern, Danielle

Southern, Danielle is an sole proprietor health care provider with primary practice located at 1420 Nw Gilman Blvd # 2604 , Issaquah WA 98027-5394. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Southern, Danielle can be contacted via phone (805) 668-8961.

Contact Information

Primary practice address
1420 Nw Gilman Blvd # 2604 Issaquah WA 98027-5394
Fax: (208) 416-6922
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X CB60997173 Washington

Profile Details

NPI number 1104473222
LBN Legal business name Southern, Danielle
Credentials CB
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2019
Last updated Aug 22nd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104473222 NPPES
Washington Other CB60997173 STATE LICENSE

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