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General NPI Number Information
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NPI Number | 1700991882
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Entity Type | Individual
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Provider Name | DANIEL LEE BANEY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 6825 PARKDALE PL STE C
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-6602
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Country | US
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Telephone | 317-981-5418
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Fax | 317-981-5429
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Provider Business Mailing Address
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Address Line | 6825 PARKDALE PL STE C
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-6602
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Country | US
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Telephone | 317-981-5418
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Fax | 317-981-5429
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 200400759A
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License Number State | IN
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