Provider Demographics
NPI:1467337444
Name:GARY, DANIELLE ELISE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELISE
Last Name:GARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRE POINTE BLVD APT 137
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4879
Mailing Address - Country:US
Mailing Address - Phone:347-595-3426
Mailing Address - Fax:
Practice Address - Street 1:1900 CENTRE POINTE BLVD APT 137
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4879
Practice Address - Country:US
Practice Address - Phone:347-595-3426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health