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General NPI Number Information
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NPI Number | 1063089613
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Entity Type | Individual
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Provider Name | KATHLEEN DANIELS PMHNP, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 5301 BUCKEYSTOWN PIKE STE 170
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City | FREDERICK
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State | MD
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Zip | 21704-8380
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Country | US
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Telephone | 240-575-9688
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Fax |
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Provider Business Mailing Address
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Address Line | 6502 N SHORE SQ
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City | NEW MARKET
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State | MD
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Zip | 21774-6443
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Country | US
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Telephone | 617-259-0282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R219138
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-149678
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License Number State | MD
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