Individual
DANIELLE MARIE GULLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1865 N RIDGE RD E STE E, LORAIN, OH 44055-3360
(440) 324-5701
Mailing address
22001 FAIRMOUNT BLVD, CLEVELAND, OH 44118-4819
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1901694-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0268076
—
OH
Enumeration date
03/24/2011
Last updated
09/16/2020
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