Provider Demographics
NPI:1346224300
Name:DANIEL, STEPHANIE SERGENT (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:SERGENT
Last Name:DANIEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E NORTHWOOD ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1224
Mailing Address - Country:US
Mailing Address - Phone:336-346-3192
Mailing Address - Fax:336-346-3197
Practice Address - Street 1:200 E NORTHWOOD ST
Practice Address - Street 2:SUITE 320
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1224
Practice Address - Country:US
Practice Address - Phone:336-346-3192
Practice Address - Fax:336-346-3197
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2417103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent