Healthcare Provider Details

I. General information

NPI: 1457931719
Provider Name (Legal Business Name): DANIELLA AYALA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N WOLF RD
WHEELING IL
60090-2924
US

IV. Provider business mailing address

1435 N WOOD ST
GRIFFITH IN
46319-1727
US

V. Phone/Fax

Practice location:
  • Phone: 219-777-1799
  • Fax:
Mailing address:
  • Phone: 219-777-1799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-143077
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: