Provider Demographics
NPI:1790090421
Name:DANIELS, MEGHAN L (LMT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:L
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 KIETZKE LN
Mailing Address - Street 2:I-206
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-5033
Mailing Address - Country:US
Mailing Address - Phone:775-826-8687
Mailing Address - Fax:
Practice Address - Street 1:4600 KIETZKE LN
Practice Address - Street 2:I-206
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-5033
Practice Address - Country:US
Practice Address - Phone:775-826-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3558225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist