| Doctor Name: | DANIELLE GEORGE |
| NPI Number: | 1073817557 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 64852 |
| Business Practice Address: | 452 Old Mammoth Road Mammoth Lakes, CA - 935462619 |
| Business Phone Number: | 7609241740 |
| Business Fax Number: | 7609241741 |
| Mailing Address: | Po Box 2619, MAMMOTH LAKES |
| State: | CA |
| Postal Code: | 935462619 |
| Phone Number: | 7609241740 |
| Fax Number: | 7609241741 |
| NPI Enumeration Date: | 12/27/2010 |
| NPI Last Update Date: | 11/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 64852 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |