Provider Information for 1508645847
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SALLY DANIELS LPC-S
Sex: Female
NPI: 1508645847
Last Updated: 2023-09-26
Certification Date: 2023-09-26
Certification Date: 2023-09-26
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508645847 | ||||||||||||
| Enumeration Date | 2023-09-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 226 PRIVATE ROAD 4882 AZLE, TX 76020-8844 United States Phone: 817-556-1762 | Fax: | ||||||||||||
| Primary Practice Address | 141 W MAIN ST AZLE, TX 76020-3117 United States Phone: 817-556-1762 | Fax: | ||||||||||||
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