| Doctor Name: | MRS. DENISE MIHELLE ADDISON |
| NPI Number: | 1508098229 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 16170 Main St Ste F Lower Lake, CA - 954577603 |
| Business Phone Number: | 7079945486 |
| Business Fax Number: | |
| Mailing Address: | Po Box 95, LOWER LAKE |
| State: | CA |
| Postal Code: | 954570095 |
| Phone Number: | 7079945486 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2009 |
| NPI Last Update Date: | 04/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |