Healthcare Provider Details

I. General information

NPI: 1093673089
Provider Name (Legal Business Name): CAMILLE DANIELS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4114 VINEDALE AVE
CINCINNATI OH
45205-2049
US

IV. Provider business mailing address

4114 VINEDALE AVE
CINCINNATI OH
45205-2049
US

V. Phone/Fax

Practice location:
  • Phone: 513-237-5981
  • Fax:
Mailing address:
  • Phone: 513-237-5981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.007292
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: