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Individual

DANIEL JACOB SELF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LMHCA

Contact information

Practice address
30 DONGAN PL APT 6G, NEW YORK, NY 10040-1556
(929) 256-2140
Mailing address
608 FLATHEAD RIVER ST, OXNARD, CA 93036-5308
(661) 674-9564

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC61409994
WA

Other

Enumeration date
10/26/2023
Last updated
10/26/2023
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