Individual
TANGLE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDD SERVICES
Contact information
Practice address
1406 MISSISSIPPI DR, WAYNESBORO, MS 39367-8901
(601) 735-3330
(601) 735-9598
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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