Provider Demographics
NPI:1346012242
Name:O'GARRO, DANIELLA DESTINA (LAPC)
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:DESTINA
Last Name:O'GARRO
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 STRATMORE PL
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-1083
Mailing Address - Country:US
Mailing Address - Phone:678-565-5881
Mailing Address - Fax:
Practice Address - Street 1:500 SUN VALLEY DR STE D2
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5636
Practice Address - Country:US
Practice Address - Phone:770-910-9162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health