Provider Demographics
NPI:1386382729
Name:DANIELS, JAYCIE TEE (RBT)
Entity type:Individual
Prefix:
First Name:JAYCIE
Middle Name:TEE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13618 E HAMPDEN GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-6529
Mailing Address - Country:US
Mailing Address - Phone:619-415-6306
Mailing Address - Fax:
Practice Address - Street 1:5700 E PIMA ST STE G
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5638
Practice Address - Country:US
Practice Address - Phone:520-232-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist