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General NPI Number Information
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NPI Number | 1720496045
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Entity Type | Individual
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Provider Name | DANIELLE VALLE CORRALES LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 04/26/2019
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Provider Practice Location Address
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Address Line | 6245 N 24TH PKWY STE 106
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City | PHOENIX
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State | AZ
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Zip | 85016-2029
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Country | US
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Telephone | 480-999-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 9205 S CALLE AZTECA
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City | GUADALUPE
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State | AZ
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Zip | 85283-2555
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-15184
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License Number State | AZ
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