Individual
STEPHANIE JILL DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
209 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
(304) 574-2100
(304) 574-2151
Mailing address
101 S EISENHOWER DR, BECKLEY, WV 25801-4929
(304) 256-7113
(304) 256-7136
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1104
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30615058
—
KY
Enumeration date
01/10/2007
Last updated
05/31/2016
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