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General NPI Number Information
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NPI Number | 1275406134
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Entity Type | Organization
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Legal Business Name | DANIEL A EDWARDS PHD
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 6857 ALDEN DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48324-2013
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Country | US
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Telephone | 773-673-0299
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N ASHLAND AVE STE 205
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City | CHICAGO
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State | IL
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Zip | 60622-8311
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Country | US
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Telephone | 773-673-0299
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL A EDWARDS
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Credential | PSYD
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Telephone | 773-673-0299
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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 |
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License Number State |
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