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General NPI Number Information
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NPI Number | 1730372855
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Entity Type | Individual
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Provider Name | DANIEL L CASIAS PH.D., LMFT
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Gender | Male
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 108 N BEHREND AVE SUITE G
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City | FARMINGTON
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State | NM
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Zip | 87401-8448
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Country | US
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Telephone | 505-326-2736
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 306
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City | BAYFIELD
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State | CO
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Zip | 81122-0306
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0614
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License Number State | NM
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