Provider Demographics
NPI:1881490647
Name:DANIELS, MARILYN
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:DANIELS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-4605
Mailing Address - Country:US
Mailing Address - Phone:531-229-2917
Mailing Address - Fax:
Practice Address - Street 1:6245 CASCADE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-4605
Practice Address - Country:US
Practice Address - Phone:531-229-2917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health