Provider Demographics
NPI:1093526824
Name:BATREZ, DANESA
Entity type:Individual
Prefix:
First Name:DANESA
Middle Name:
Last Name:BATREZ
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 1:4212 RAVINE GAP DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-3054
Mailing Address - Country:US
Mailing Address - Phone:347-654-5690
Mailing Address - Fax:
Practice Address - Street 1:1024 CENTERBROOKE LN STE F
Practice Address - Street 2:UNIT 223
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8294
Practice Address - Country:US
Practice Address - Phone:347-654-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275009557Medicaid