Healthcare Provider Details

I. General information

NPI: 1104856178
Provider Name (Legal Business Name): DALE R. HALPAIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12001 Q ST
OMAHA NE
68137-3542
US

IV. Provider business mailing address

12001 Q ST
OMAHA NE
68137-3542
US

V. Phone/Fax

Practice location:
  • Phone: 402-592-0328
  • Fax: 402-592-4170
Mailing address:
  • Phone: 402-592-0328
  • Fax: 402-592-4170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number277
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: