Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3571 | CO |
NPI | 1013296789 |
---|---|
Provider Name | Dr. Gennea Adelle Danks |
First Address | Mitchell, SD 57301-3894 |
Second Address | Mitchell, SD 57301-3894 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2011 |
Last Update Date | 29/03/2012 |