Individual
MARK RICHARD DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, MBA, MA
Contact information
Practice address
17113 MINNETONKA BLVD, WEST ENTRANCE, MINNETONKA, MN 55345
(612) 306-9099
Mailing address
4740 144TH ST W, APPLE VALLEY, MN 55124-6996
(612) 306-9099
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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