Healthcare Provider Details

I. General information

NPI: 1598670358
Provider Name (Legal Business Name): CHAYSE DANIELS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 CAMBRIDGE ST
FAYETTEVILLE NC
28303-5300
US

IV. Provider business mailing address

406 EDWINSTOWE AVE
FAYETTEVILLE NC
28311-1161
US

V. Phone/Fax

Practice location:
  • Phone: 253-444-7603
  • Fax:
Mailing address:
  • Phone: 253-444-7603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: