Provider Information for 1396465878
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DANIELLE ROSE BRADY NCC, LPC
Sex: Female
NPI: 1396465878
Last Updated: 2022-09-02
Certification Date: 2022-09-02
Certification Date: 2022-09-02
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1396465878 | ||||||||
| Enumeration Date | 2022-09-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4820 POWDERHORN DR RAPID CITY, SD 57702-4801 United States Phone: 605-641-3219 | Fax: | ||||||||
| Primary Practice Address | 4820 POWDERHORN DR RAPID CITY, SD 57702-4801 United States Phone: 605-641-3219 | Fax: | ||||||||
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