Provider Demographics
NPI:1801137930
Name:DANIELS, OLLIE (RN)
Entity type:Individual
Prefix:MS
First Name:OLLIE
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 OAKLEY ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2005
Mailing Address - Country:US
Mailing Address - Phone:845-486-6330
Mailing Address - Fax:845-486-6339
Practice Address - Street 1:26 OAKLEY ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2005
Practice Address - Country:US
Practice Address - Phone:845-486-6330
Practice Address - Fax:845-486-6339
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY393568-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health