Individual
DANIELLE OBANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 1/2 W GENEVA ST, ELKHORN, WI 53121-1722
(262) 723-3424
Mailing address
1 1/2 W GENEVA ST, ELKHORN, WI 53121-1722
(262) 723-3424
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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