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NPI Code Detail

MEDICARE: JESSICA DANIELS

MEDICARE: JESSICA DANIELS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YP2500XProfessional CounselorC.1801521OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083192264
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA DANIELS
Provider Business Mailing Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7031 CORPORATE WAY STE 103
Second Line :
City : DAYTON
State : OH
Zip : 45459-4262
Country : US
Telephone Number : 937-619-9089
Fax Number : 937-265-6028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2018
Last Update Date : 07/07/2021

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Directions to “ JESSICA DANIELS ” Practice Location

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