Provider Demographics
NPI:1669831517
Name:DANIELS, T.C. II
Entity Type:Individual
Prefix:MR
First Name:T.C.
Middle Name:
Last Name:DANIELS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 ARDMORE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2200
Mailing Address - Country:US
Mailing Address - Phone:703-969-9803
Mailing Address - Fax:
Practice Address - Street 1:1129 ARDMORE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2200
Practice Address - Country:US
Practice Address - Phone:703-969-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor