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General NPI Number Information
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NPI Number | 1427696202
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Entity Type | Organization
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Legal Business Name | KIMBERLY M DANIELS LLC
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 682 PROSPECT AVE
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City | HARTFORD
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State | CT
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Zip | 06105-4238
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Country | US
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Telephone | 860-231-2227
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Fax |
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Provider Business Mailing Address
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Address Line | 24 TROTWOOD DR
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City | WEST HARTFORD
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State | CT
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Zip | 06117-1643
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Country | US
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Telephone | 860-881-3549
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. KIMBERLY DANIELS
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Credential | PSY.D.
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Telephone | 860-231-2227
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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 |
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License Number State |
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