Individual
DANIELLE CAROL ATHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2031
Mailing address
2307 17TH STREET, ROCK ISLAND, IL 61254
(309) 779-2031
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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