| Doctor Name: | JESSICA LEIGH DANIELS |
| NPI Number: | 1033459656 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCA |
| License Number: | A9728 |
| Business Practice Address: | 839 Majestic Ct Ste 9 Gastonia, NC - 280545152 |
| Business Phone Number: | 7046483420 |
| Business Fax Number: | |
| Mailing Address: | 1441 Ashcraft Ln Apt K, CHARLOTTE |
| State: | NC |
| Postal Code: | 282092466 |
| Phone Number: | 4075574180 |
| Fax Number: | |
| NPI Enumeration Date: | 02/19/2013 |
| NPI Last Update Date: | 02/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | A9728 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |