MEDICARE: DR. JANE E DANIEL PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	001150	IA

General Provider Information

NPI Number	:	1124189436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE E DANIEL PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 672
Second Line	:
City	:	ANKENY
State	:	IA
Zip	:	50021-0672
Country	:	US
Telephone Number	:	515-805-0956
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 LOCUST ST PMB 126
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50309-4104
Country	:	US
Telephone Number	:	515-805-0956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	12/27/2024

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