MEDICARE: AMANDA MARIE DANIEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	84969	TX

General Provider Information

NPI Number	:	1326797374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE DANIEL

Provider Business Mailing Address
First Line	:	1600 JONES DR APT 209
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-3528
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 JONES DR APT 209
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-3528
Country	:	US
Telephone Number	:	682-266-1703
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2022
Last Update Date	:	03/18/2022

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Directions to “ AMANDA MARIE DANIEL ” Practice Location

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