Provider Demographics
NPI:1033639828
Name:DANIELE, MEGAN M
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:M
Last Name:DANIELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 N FM 620 RD STE 100&400
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-4007
Mailing Address - Country:US
Mailing Address - Phone:512-920-5171
Mailing Address - Fax:
Practice Address - Street 1:8300 N FM 620 RD STE 100&400
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-4007
Practice Address - Country:US
Practice Address - Phone:512-920-5171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88064101YP2500X
TX4329103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional