Provider Demographics
NPI:1457933269
Name:DANIELS, KIMBERLY D (NA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:DANIELS
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 GUS THOMASSON RD APT 1511
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6218
Mailing Address - Country:US
Mailing Address - Phone:972-750-9285
Mailing Address - Fax:
Practice Address - Street 1:3750 GUS THOMASSON RD APT 1511
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6218
Practice Address - Country:US
Practice Address - Phone:972-750-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor