Provider Demographics
NPI:1700282035
Name:DARBY, DANIELLE (BACHELOR OF SOCIAL W)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DARBY
Suffix:
Gender:F
Credentials:BACHELOR OF SOCIAL W
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5827 OLD MILL TRCE
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-4150
Mailing Address - Country:US
Mailing Address - Phone:973-592-4610
Mailing Address - Fax:
Practice Address - Street 1:3236 HIGHWAY 278
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2402
Practice Address - Country:US
Practice Address - Phone:973-592-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator