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NPI 1033279237

NPI 1033279237 : PAUL LEE DANIELS PSYD : FORT SCOTT, KS

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General NPI Number Information
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    NPI Number           |    1033279237
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    Entity Type          |    Individual 
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    Provider Name        |    PAUL LEE DANIELS PSYD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/11/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    710 W 8TH 
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    City                 |    FORT SCOTT
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    State                |    KS
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    Zip                  |    66701
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    Country              |    US
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    Telephone            |    620-223-8590
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    Fax                  |    620-223-8592
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Provider Business Mailing Address
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    Address Line         |    710 W 8TH 
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    City                 |    FORT SCOTT
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    State                |    KS
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    Zip                  |    66701
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    Country              |    US
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    Telephone            |    620-223-8590
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    Fax                  |    620-223-8592
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    054
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    License Number State |    KS
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Taxonomy #2
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    471
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    License Number State |    KS
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