Provider Demographics
NPI:1558682922
Name:HAZLETT, DANIELLE RACHEL (MS, LMHC, CMHS)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RACHEL
Last Name:HAZLETT
Suffix:
Gender:F
Credentials:MS, LMHC, CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 DUPONT STREET, #1
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4021
Mailing Address - Country:US
Mailing Address - Phone:360-647-8011
Mailing Address - Fax:360-647-4761
Practice Address - Street 1:700 DUPONT STREET
Practice Address - Street 2:#1
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4021
Practice Address - Country:US
Practice Address - Phone:360-647-8011
Practice Address - Fax:360-647-4761
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60018117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health