Provider Demographics
NPI:1912574229
Name:DANIELS, LONDON AMARIS
Entity Type:Individual
Prefix:
First Name:LONDON
Middle Name:AMARIS
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 TOWN PARK DR APT 3132
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2625
Mailing Address - Country:US
Mailing Address - Phone:972-352-0501
Mailing Address - Fax:
Practice Address - Street 1:8701 TOWN PARK DR APT 3132
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2625
Practice Address - Country:US
Practice Address - Phone:972-352-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician