Individual
MRS. DANIELLE MARIE SPRAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7712 FOXTAIL PNES, LIVERPOOL, NY 13090-3615
(315) 412-2759
Mailing address
7712 FOXTAIL PNES, LIVERPOOL, NY 13090-3615
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1038111
CDR REGISTRATION
NY
Enumeration date
03/29/2021
Last updated
03/29/2021
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