Provider Demographics
NPI:1407964471
Name:DANIELS, STEPHEN F (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:DANIELS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1912 BISCAYNE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-3952
Mailing Address - Country:US
Mailing Address - Phone:501-257-3318
Mailing Address - Fax:501-257-2308
Practice Address - Street 1:2200 FT. ROOTS DRIVE
Practice Address - Street 2:116D/NLR
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72214
Practice Address - Country:US
Practice Address - Phone:501-257-3318
Practice Address - Fax:501-257-2308
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR87-16P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical