Provider Demographics
NPI:1952918484
Name:DANIEL, ANDREA Y
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:Y
Last Name:DANIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:Y
Other - Last Name:DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WATKINS
Mailing Address - Street 1:6040 WALTERS LOOP
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5368
Mailing Address - Country:US
Mailing Address - Phone:706-341-9535
Mailing Address - Fax:
Practice Address - Street 1:6040 WALTERS LOOP
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-5368
Practice Address - Country:US
Practice Address - Phone:706-341-9535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator