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General NPI Number Information
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NPI Number | 1366142853
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Entity Type | Organization
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Legal Business Name | DANIELS DYNAMIC THERAPY AND CONSULTING , LLC
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 4227 DUNWOOD TER
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1323
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Country | US
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Telephone | 443-858-1383
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Fax |
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Provider Business Mailing Address
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Address Line | 4227 DUNWOOD TER
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1323
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Country | US
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Telephone | 443-858-1383
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER- OWNER
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Name | OMOTAYO DANIELS
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Credential | LCSW-C, LICSW, LCSW
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Telephone | 443-858-1383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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