Provider Demographics
NPI:1447570171
Name:HATEM, DANIELLE REBECCA (LICSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:REBECCA
Last Name:HATEM
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3B TAGGART DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5592
Mailing Address - Country:US
Mailing Address - Phone:603-546-7839
Mailing Address - Fax:
Practice Address - Street 1:3B TAGGART DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5592
Practice Address - Country:US
Practice Address - Phone:603-546-7839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13081041C0700X
MA11333351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical