Provider Demographics
NPI:1538801253
Name:BALD, DANIELLE MARIE (APSW, MSW)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MARIE
Last Name:BALD
Suffix:
Gender:F
Credentials:APSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 N 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-2706
Mailing Address - Country:US
Mailing Address - Phone:181-554-1334
Mailing Address - Fax:
Practice Address - Street 1:3801 N 88TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-2706
Practice Address - Country:US
Practice Address - Phone:181-554-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI363LPO808X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical