Individual
DANIELLE ANGELISANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3044 DUE WEST RD, DALLAS, GA 30157-2125
(770) 443-9672
Mailing address
3044 DUE WEST RD, DALLAS, GA 30157-2125
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT006047
GA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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