Healthcare Provider Details

I. General information

NPI: 1033790928
Provider Name (Legal Business Name): DANIELLE ARNETT CT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30811 LAKE LOGAN RD
LOGAN OH
43138-9546
US

IV. Provider business mailing address

30811 LAKE LOGAN RD
LOGAN OH
43138-9546
US

V. Phone/Fax

Practice location:
  • Phone: 740-603-7756
  • Fax: 740-777-4014
Mailing address:
  • Phone: 740-603-7756
  • Fax: 740-777-4014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2103119-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2404210
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: