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NPI Code Detail

MEDICARE: MRS. DANIELLE DAWN LA HA M.A.

MEDICARE: MRS. DANIELLE DAWN LA HA M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor180.00875IL

General Provider Information

NPI Number : 1962773622
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANIELLE DAWN LA HA M.A.
Provider Business Mailing Address
First Line : 309 NEW INDIAN TRAIL CT
Second Line :
City : AURORA
State : IL
Zip : 60506-2411
Country : US
Telephone Number : 630-966-4000
Fax Number :
Provider Business Practice Location Address
First Line : 309 NEW INDIAN TRAIL CT
Second Line :
City : AURORA
State : IL
Zip : 60506-2411
Country : US
Telephone Number : 630-966-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2012
Last Update Date : 12/12/2018

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