Provider Demographics
NPI:1679808844
Name:DANIELS, ANGEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:
Last Name:DANIELS
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 1:31673 HILLBROOK ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3390
Mailing Address - Country:US
Mailing Address - Phone:831-227-0398
Mailing Address - Fax:
Practice Address - Street 1:31673 HILLBROOK ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3390
Practice Address - Country:US
Practice Address - Phone:831-227-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical