Provider Demographics
NPI:1043073851
Name:RECABARREN, DANIELA (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:
Last Name:RECABARREN
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9309 COTTON GUM RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3697
Mailing Address - Country:US
Mailing Address - Phone:305-546-5901
Mailing Address - Fax:
Practice Address - Street 1:9309 COTTON GUM RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-3697
Practice Address - Country:US
Practice Address - Phone:305-546-5901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5230103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling