Healthcare Provider Details

I. General information

NPI: 1770595852
Provider Name (Legal Business Name): ORNA DANIEL GOLDWATER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ORNA DANIEL GOLDWATER PHD

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 CONNECTICUT AVE NW STE 137B
WASHINGTON DC
20008
US

IV. Provider business mailing address

3000 CONNECTICUT AVE NW STE 137B
WASHINGTON DC
20008-2549
US

V. Phone/Fax

Practice location:
  • Phone: 469-556-7128
  • Fax:
Mailing address:
  • Phone: 469-556-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY1001392
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY1001392
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY1001392
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY1001392
License Number StateDC
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1001392
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: