| Doctor Name: | MR. MICHAEL NA DANIELS |
| NPI Number: | 1053682815 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCAS |
| License Number: | 1593 |
| Business Practice Address: | 105 Winter Ct Selma, NC - 275762189 |
| Business Phone Number: | 9193009338 |
| Business Fax Number: | |
| Mailing Address: | 105 Winter Court, SELMA |
| State: | NC |
| Postal Code: | 27576 |
| Phone Number: | 9193009338 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2012 |
| NPI Last Update Date: | 01/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1593 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |