Provider Demographics
NPI:1144044132
Name:CALOURA, DANAE COTA-AVILA
Entity type:Individual
Prefix:
First Name:DANAE
Middle Name:COTA-AVILA
Last Name:CALOURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANAE
Other - Middle Name:
Other - Last Name:COTA-AVILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:340 CONCORD PL APT 2
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1771
Mailing Address - Country:US
Mailing Address - Phone:248-495-1414
Mailing Address - Fax:
Practice Address - Street 1:1475 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2653
Practice Address - Country:US
Practice Address - Phone:313-278-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst