# DANIELS DISCOVERY DYNAMICS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376958546
- **Authorized official:** PREZILLIC DANIELS MA, LPC, RPT (OWNER/COUNSELOR)
- **Authorized official phone:** (843) 661-6030

## Contact information

- **Practice address:** 1803 CHEROKEE RD, FLORENCE, SC 29501-4184
- **Practice address phone:** (843) 661-6030
- **Practice address fax:** (843) 679-2633
- **Mailing address:** 1803 CHEROKEE RD, FLORENCE, SC 29501-4184
- **Mailing address phone:** (843) 661-6030
- **Mailing address fax:** (843) 679-2633

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 5468 | SC | Yes |
| 305R00000X | Preferred Provider Organization | 5468 | SC | — |

## Other

- **Enumeration date:** 06/26/2014
- **Last updated:** 06/26/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PC1260 | — | SC |