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General NPI Number Information
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NPI Number | 1336138940
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Entity Type | Individual
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Provider Name | ROBERT W DANIELS PHD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 1617 W BOGART RD SUITE 5
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City | SANDUSKY
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State | OH
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Zip | 44870-5787
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Country | US
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Telephone | 419-626-8226
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Fax | 419-621-0457
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Provider Business Mailing Address
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Address Line | 1617 W BOGART RD SUITE 5
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City | SANDUSKY
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State | OH
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Zip | 44870-5787
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Country | US
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Telephone | 419-626-8226
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Fax | 419-621-0457
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 587
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License Number State | OH
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