Individual
DANIELLE LONGFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 MEMORIAL MEDICAL DR, GREENVILLE, SC 29605-4452
(706) 842-5330
(706) 842-5340
Mailing address
3736 EXECUTIVE CENTER DR, AUGUSTA, GA 30907-2360
(706) 842-5330
(706) 842-5340
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
6199
SC
Other
Enumeration date
01/29/2019
Last updated
08/25/2021
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