Doctor Name: | MS. JEANNETTE MARIE DADDONO |
NPI Number: | 1255613196 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC |
License Number: | 178007422 |
Business Practice Address: | 9845 W Roosevelt Rd Westchester, IL - 601542758 |
Business Phone Number: | 7086812325 |
Business Fax Number: | 7083435977 |
Mailing Address: | 9845 W Roosevelt Rd, WESTCHESTER |
State: | IL |
Postal Code: | 601542758 |
Phone Number: | 7086812325 |
Fax Number: | 7083435977 |
NPI Enumeration Date: | 09/16/2011 |
NPI Last Update Date: | 09/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 178007422 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |