Provider Demographics
NPI:1700250255
Name:DANIELS, JOSHUA ALEXANDER
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALEXANDER
Last Name:DANIELS
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 1:515 MULLICA HILL RD APT A237
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1053
Mailing Address - Country:US
Mailing Address - Phone:856-236-3759
Mailing Address - Fax:
Practice Address - Street 1:515 MULLICA HILL RD. APT A237
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028
Practice Address - Country:US
Practice Address - Phone:856-236-3759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health