Provider Demographics
NPI:1972740272
Name:DANIEL, NANCY MARIA (LPC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:MARIA
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2517
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7701
Mailing Address - Country:US
Mailing Address - Phone:479-936-6309
Mailing Address - Fax:
Practice Address - Street 1:327 E 123RD CT S
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-4297
Practice Address - Country:US
Practice Address - Phone:479-936-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK793101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional