Healthcare Provider Details

I. General information

NPI: 1821903873
Provider Name (Legal Business Name): TONDELYNIA DANIELS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N GREENE ST OFC B
SNOW HILL NC
28580-1410
US

IV. Provider business mailing address

414 ADLER LN
GOLDSBORO NC
27530-5520
US

V. Phone/Fax

Practice location:
  • Phone: 336-275-7973
  • Fax:
Mailing address:
  • Phone: 252-367-8067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number31874
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: