Provider Demographics
NPI:1134871148
Name:HIDALGO, DANIELA (MS)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:HIDALGO
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 1:40 BUCHANAN RD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08559-1503
Mailing Address - Country:US
Mailing Address - Phone:949-307-6573
Mailing Address - Fax:
Practice Address - Street 1:40 BUCHANAN RD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:NJ
Practice Address - Zip Code:08559-1503
Practice Address - Country:US
Practice Address - Phone:949-307-6573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-19-39416103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst