Provider Demographics
NPI:1316462641
Name:RENDER, DANIELLE (MS)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:RENDER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:RENDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:109 ANDERSON ST SE STE 101
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 ANDERSON ST SE STE 101
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8610
Practice Address - Country:US
Practice Address - Phone:706-406-3404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health