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General NPI Number Information
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NPI Number | 1265770788
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Entity Type | Individual
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Provider Name | MISS DANIELLE CHRISTINA LAYCOOK
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Gender | Female
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 637 E ALBERTONI ST 109
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City | CARSON
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State | CA
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Zip | 90746-1539
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Country | US
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Telephone | 310-532-0063
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 EMERALD ST 15
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City | TORRANCE
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State | CA
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Zip | 90503-3723
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Country | US
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Telephone | 805-907-6555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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