Healthcare Provider Details

I. General information

NPI: 1164484937
Provider Name (Legal Business Name): DANIEL J MAUER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 02/15/2022
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 NE 10TH ST APT 1
POMPANO BEACH FL
33062-3947
US

IV. Provider business mailing address

3200 NE 10TH ST APT 1
POMPANO BEACH FL
33062-3947
US

V. Phone/Fax

Practice location:
  • Phone: 410-746-6530
  • Fax:
Mailing address:
  • Phone: 443-777-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: