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Individual
MRS. ANDREA JOYCE DATTADEEN
Active
Individual
MRS. ANDREA JOYCE DATTADEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401015974
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401015974
STATE THERAPIST LICENSE
MI
Enumeration date
06/12/2017
Last updated
06/12/2017
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