Provider Demographics
NPI:1407981962
Name:STAATS, DANIEL D (MRE, MA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:STAATS
Suffix:
Gender:M
Credentials:MRE, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 HIGHWAY 225 S
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-6044
Mailing Address - Country:US
Mailing Address - Phone:706-517-4357
Mailing Address - Fax:
Practice Address - Street 1:4439 HIGHWAY 225 S
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:GA
Practice Address - Zip Code:30705-6044
Practice Address - Country:US
Practice Address - Phone:706-517-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral