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NPI 1639680812

NPI 1639680812 : DANIEL MCDONNELL PH.D : TUCSON, AZ

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General NPI Number Information
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    NPI Number           |    1639680812
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    Entity Type          |    Individual 
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    Provider Name        |    DANIEL MCDONNELL PH.D
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/16/2017
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    Last Update Date     |    10/16/2017
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Provider Practice Location Address
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    Address Line         |    8221 E OCOTILLO DR 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85750-9667
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    Country              |    US
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    Telephone            |    520-760-4014
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8221 E OCOTILLO DR 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85750-9667
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    Country              |    US
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    Telephone            |    520-760-4014
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    Fax                  |    
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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       |    3648
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    License Number State |    AZ
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