Healthcare Provider Details

I. General information

NPI: 1245906098
Provider Name (Legal Business Name): MEGAN ELIZABETH DANIAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 08/01/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MILL RUN CT
MEDFORD NJ
08055-2436
US

IV. Provider business mailing address

85 BENTWOOD DR
WESTAMPTON NJ
08060-5641
US

V. Phone/Fax

Practice location:
  • Phone: 609-953-5793
  • Fax:
Mailing address:
  • Phone: 973-525-2288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: