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General NPI Number Information
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NPI Number | 1326582099
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Entity Type | Organization
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Legal Business Name | DANIEL GARRISON
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 4810B SPICEWOOD SPRINGS RD
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City | AUSTIN
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State | TX
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Zip | 78759-8740
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Country | US
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Telephone | 512-773-1267
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Fax |
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Provider Business Mailing Address
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Address Line | 4802 RED RIVER ST
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City | AUSTIN
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State | TX
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Zip | 78751-3331
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Country | US
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Telephone | 512-773-1267
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DANIEL GARRISON
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Credential | PH.D.
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Telephone | 512-773-1267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 37430
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License Number State | TX
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