Individual
DANIELLE MARONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
220 W BONG ST STE 153, FAIRCHILD AIR FORCE BASE, WA 99011-9465
(509) 247-4029
Mailing address
2602 W PARKWAY DR, SPOKANE, WA 99208-6395
(509) 954-3356
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00009607
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00009607
LICENSED INDEPENDENT CLINICAL SOCIAL WORKER
WA
Enumeration date
07/27/2012
Last updated
07/30/2012
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