Provider Demographics
NPI:1851993737
Name:MAGEE, DARIELLE ANTOINETTE
Entity Type:Individual
Prefix:
First Name:DARIELLE
Middle Name:ANTOINETTE
Last Name:MAGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3894 W CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3869
Mailing Address - Country:US
Mailing Address - Phone:586-935-2409
Mailing Address - Fax:
Practice Address - Street 1:14231 N 7TH ST STE B7
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4362
Practice Address - Country:US
Practice Address - Phone:602-228-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator