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General NPI Number Information
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NPI Number | 1629955406
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Entity Type | Individual
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Provider Name | DANIEL B. WOLOSZYN
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Gender | Male
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 13450 BECKWITH DR
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City | CARMEL
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State | IN
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Zip | 46074-8337
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Country | US
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Telephone | 847-826-0476
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Fax | 847-826-0476
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Provider Business Mailing Address
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Address Line | 13450 BECKWITH DR
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City | CARMEL
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State | IN
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Zip | 46074-8337
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Country | US
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Telephone | 847-826-0476
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Fax | 847-826-0476
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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 | 20040717
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071004523
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License Number State | IL
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