Provider Demographics
NPI:1447551684
Name:ALBERT, DANIELE (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:DANIELE
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 BROOKHAVEN AVE NE
Mailing Address - Street 2:#547
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3253
Mailing Address - Country:US
Mailing Address - Phone:404-414-4012
Mailing Address - Fax:
Practice Address - Street 1:305 BROOKHAVEN AVE NE
Practice Address - Street 2:#547
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3253
Practice Address - Country:US
Practice Address - Phone:404-414-4012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0027132255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer