=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295047520
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL P FOLEY LMFT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2010
-----------------------------------------------------
Last Update Date | 07/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11 PRESTON RD
-----------------------------------------------------
City | WINDSOR LOCKS
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06096-2820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-623-2742
-----------------------------------------------------
Fax | 860-623-0189
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 PRESTON RD
-----------------------------------------------------
City | WINDSOR LOCKS
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06096-2820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-623-2742
-----------------------------------------------------
Fax | 860-623-0189
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 001373
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------