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General NPI Number Information
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NPI Number | 1356697171
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Entity Type | Individual
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Provider Name | STEVEN MICHAEL DANIELS JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 2006 NEW GARDEN RD UNIT 202
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City | GREENSBORO
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State | NC
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Zip | 27410-2566
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Country | US
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Telephone | 336-288-6440
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 FLANDERS ST
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City | GARNER
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State | NC
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Zip | 27529-4406
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Country | US
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Telephone | 919-906-2891
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 102985
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License Number State | NC
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