Provider Demographics
NPI:1275109290
Name:STOWERS, DANETTE L (NONE)
Entity Type:Individual
Prefix:MISS
First Name:DANETTE
Middle Name:L
Last Name:STOWERS
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:DANETTE
Other - Middle Name:L
Other - Last Name:STOWERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4695 SUGARLOAF PKWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6983
Mailing Address - Country:US
Mailing Address - Phone:470-798-8245
Mailing Address - Fax:
Practice Address - Street 1:4695 SUGARLOAF PKWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-6983
Practice Address - Country:US
Practice Address - Phone:470-798-8245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health