Provider Demographics
NPI:1861137010
Name:WISE, DANIELLE (PHD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:WISE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:DANIELLE
Other - Last Name:SANCHEZ WISE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:6321 ESTES ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3128
Mailing Address - Country:US
Mailing Address - Phone:303-948-8311
Mailing Address - Fax:
Practice Address - Street 1:6321 ESTES ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3128
Practice Address - Country:US
Practice Address - Phone:303-948-8311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health