Provider Demographics
NPI:1003415498
Name:EMINA, DANIELLE MONIQUE' (LPC)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MONIQUE'
Last Name:EMINA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3338 LINDALE CT
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-1313
Mailing Address - Country:US
Mailing Address - Phone:678-548-8786
Mailing Address - Fax:
Practice Address - Street 1:3338 LINDALE CT
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-1313
Practice Address - Country:US
Practice Address - Phone:678-548-8786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional