Provider Demographics
NPI:1760501019
Name:DANIELS, LINDA ELLEN (OT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ELLEN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 COUNTRY RD.
Mailing Address - Street 2:
Mailing Address - City:QUALICUM BEACH,
Mailing Address - State:BC
Mailing Address - Zip Code:V9K 2S3
Mailing Address - Country:CA
Mailing Address - Phone:250-752-2999
Mailing Address - Fax:250-752-2999
Practice Address - Street 1:11623 ARBOR STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68133-2934
Practice Address - Country:US
Practice Address - Phone:866-334-1919
Practice Address - Fax:402-334-6015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00004382171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT00004382OtherOCCUPATIONAL THERAPIST