Provider Demographics
NPI:1851791511
Name:WALDEN, DANIEL LEE
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LEE
Last Name:WALDEN
Suffix:
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 1:1400 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-8011
Mailing Address - Country:US
Mailing Address - Phone:904-428-7548
Mailing Address - Fax:
Practice Address - Street 1:1400 JAMES ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-8011
Practice Address - Country:US
Practice Address - Phone:904-428-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor