Provider Demographics
NPI:1376224659
Name:ROVIRA, DANIELLE ANNE (PLPC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ANNE
Last Name:ROVIRA
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 E SIMCOE ST APT 6
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6565
Mailing Address - Country:US
Mailing Address - Phone:504-650-4040
Mailing Address - Fax:
Practice Address - Street 1:803 COOLIDGE BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2354
Practice Address - Country:US
Practice Address - Phone:504-650-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC8359101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health