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General NPI Number Information
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NPI Number | 1619009107
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Entity Type | Organization
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Legal Business Name | DANIEL E. KRUGER, LLC
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Dates
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Enumeration Date | 03/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6612 E CARONDELET DR
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City | TUCSON
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State | AZ
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Zip | 85710-2119
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Country | US
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Telephone | 520-981-2511
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Fax | 520-514-5233
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Provider Business Mailing Address
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Address Line | 5635 E HOLMES ST
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City | TUCSON
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State | AZ
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Zip | 85711-2447
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Country | US
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Telephone | 520-981-2511
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Fax | 520-514-5233
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL E KRUGER
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Credential | PHD
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Telephone | 520-981-2511
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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 | 3667
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License Number State | AZ
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