Individual
DANIELLE M FANELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CSR, LD
Contact information
Practice address
3002 W WALLACE AVE, TAMPA, FL 33611-4439
(609) 617-7615
Mailing address
3002 W WALLACE AVE, TAMPA, FL 33611-4439
(609) 617-7615
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND10925
FL
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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