Provider Demographics
NPI:1558144014
Name:DANIELS, TEASHA
Entity Type:Individual
Prefix:
First Name:TEASHA
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 SW 59TH ST APT 110
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73119-6428
Mailing Address - Country:US
Mailing Address - Phone:212-390-0136
Mailing Address - Fax:
Practice Address - Street 1:425 E TONHAWA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5842
Practice Address - Country:US
Practice Address - Phone:405-561-7652
Practice Address - Fax:405-701-8420
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator