Doctor Name: | DANIELLE MANN |
NPI Number: | 1063810729 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 100 South St Southbridge, MA - 015504051 |
Business Phone Number: | 5087659771 |
Business Fax Number: | |
Mailing Address: | 6 Cider Mill Rd, NORTH BROOKFIELD |
State: | MA |
Postal Code: | 015351002 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/11/2014 |
NPI Last Update Date: | 12/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |