Provider Demographics
NPI:1477396547
Name:GUALBERTO, DANNIELLE J
Entity type:Individual
Prefix:
First Name:DANNIELLE
Middle Name:J
Last Name:GUALBERTO
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 1:1418 E 9TH ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-2926
Mailing Address - Country:US
Mailing Address - Phone:775-688-9738
Mailing Address - Fax:
Practice Address - Street 1:1698 MEADOW WOOD LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6707
Practice Address - Country:US
Practice Address - Phone:775-637-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician