Provider Demographics
NPI:1245538602
Name:COLLETTE, DANIELLE (MA)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:COLLETTE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10203 DEAN POINT PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5950
Mailing Address - Country:US
Mailing Address - Phone:407-808-0448
Mailing Address - Fax:
Practice Address - Street 1:1025 S SEMORAN BLVD
Practice Address - Street 2:SUITE 1093
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-5523
Practice Address - Country:US
Practice Address - Phone:407-394-1909
Practice Address - Fax:407-315-0048
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor