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General NPI Number Information
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NPI Number | 1538324595
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Entity Type | Organization
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Legal Business Name | HEIDI DANIELS, PH.D., P.A.
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 65 DUKE ST.
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678
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Country | US
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Telephone | 301-943-2245
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Fax | 410-257-5286
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Provider Business Mailing Address
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Address Line | PO BOX 160
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City | CHESAPEAKE BEACH
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State | MD
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Zip | 20732-0160
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Country | US
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Telephone | 301-943-2245
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Fax | 410-257-5286
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HEIDI DANIELS
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Credential | PH.D.
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Telephone | 301-943-2245
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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 | 3077
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License Number State | MD
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