Provider Demographics
NPI:1154195642
Name:DANIELS, JARICIA GWENDOLYN
Entity type:Individual
Prefix:
First Name:JARICIA
Middle Name:GWENDOLYN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 BELL FLOWER DR
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2186
Mailing Address - Country:US
Mailing Address - Phone:469-536-8247
Mailing Address - Fax:972-502-9717
Practice Address - Street 1:3109 BELL FLOWER DR
Practice Address - Street 2:
Practice Address - City:OAK POINT
Practice Address - State:TX
Practice Address - Zip Code:75068-2186
Practice Address - Country:US
Practice Address - Phone:469-536-8247
Practice Address - Fax:972-502-9717
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health