Provider Demographics
NPI:1497981096
Name:DANIEL, REAGAN L (AUD, MA)
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:L
Last Name:DANIEL
Suffix:
Gender:F
Credentials:AUD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 18TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5831
Mailing Address - Country:US
Mailing Address - Phone:972-643-8634
Mailing Address - Fax:214-427-0937
Practice Address - Street 1:920 18TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5831
Practice Address - Country:US
Practice Address - Phone:972-643-8634
Practice Address - Fax:214-427-0937
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88397101YP2500X
TX80167231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist