Individual
DANIELLE LARAE LARATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
207 FAIRMONT AVE, FAIRMONT, WV 26554-2710
(681) 404-6869
Mailing address
207 FAIRMONT AVE, FAIRMONT, WV 26554-2710
(681) 404-6869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00943635
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP00943635
SOCIAL WORK LICENSE
WV
Enumeration date
09/20/2021
Last updated
09/20/2021
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