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General NPI Number Information
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NPI Number | 1417831090
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Entity Type | Individual
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Provider Name | LATOYA DIXON DANIELS QMHS AS, CMS
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 400 E STATE ST STE D
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City | ATHENS
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State | OH
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Zip | 45701-1870
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Country | US
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Telephone | 866-534-2639
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Fax | 800-480-7578
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Provider Business Mailing Address
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Address Line | 5012 HAWKSTONE DR
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City | SANFORD
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State | FL
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Zip | 32771-5414
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Country | US
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Telephone | 407-285-9827
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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