Provider Demographics
NPI:1861120313
Name:DIPAOLO, DANIELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:DIPAOLO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8938 W QUAIL AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2427
Mailing Address - Country:US
Mailing Address - Phone:818-699-7243
Mailing Address - Fax:
Practice Address - Street 1:8938 W QUAIL AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2427
Practice Address - Country:US
Practice Address - Phone:818-699-7243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005505103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical