Healthcare Provider Details

I. General information

NPI: 1659400844
Provider Name (Legal Business Name): DANIELLE MICHELLE VIOLA LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PARMENTER RD
LONDONDERRY NH
03053-3280
US

IV. Provider business mailing address

138 HIGH RANGE RD
LONDONDERRY NH
03053-3041
US

V. Phone/Fax

Practice location:
  • Phone: 603-437-2069
  • Fax:
Mailing address:
  • Phone: 603-434-4122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number421
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: