Individual
JESSICA DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7031 CORPORATE WAY STE 103, DAYTON, OH 45459-4262
(937) 619-9089
(937) 265-6028
Mailing address
1744 PAYNE AVE, CLEVELAND, OH 44114-2910
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.1801521
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0394996
—
OH
Enumeration date
07/31/2018
Last updated
07/07/2021
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