Provider Demographics
NPI:1841188489
Name:DANIELS, MARIYA ANTOINETTE
Entity type:Individual
Prefix:
First Name:MARIYA
Middle Name:ANTOINETTE
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 1:425 E FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08010-1844
Mailing Address - Country:US
Mailing Address - Phone:609-931-5257
Mailing Address - Fax:
Practice Address - Street 1:820 BEAR TAVERN RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-1021
Practice Address - Country:US
Practice Address - Phone:973-314-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician