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NPI Code Detail

MEDICARE: DANIEL J. LONOWSKI, PH. D., A PROFESSIONAL CORPORATION

MEDICARE: DANIEL J. LONOWSKI, PH. D., A PROFESSIONAL CORPORATION
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
1103TC0700XClinical Psychologist299LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120589OTHERLABLUE CROSS

General Provider Information

NPI Number : 1225194368
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANIEL J. LONOWSKI, PH. D., A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 4703 BAYOU COURT DR
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-2564
Country : US
Telephone Number : 318-443-2338
Fax Number : 318-443-0258
Provider Business Practice Location Address
First Line : 1605 MURRAY ST
Second Line : SUITE 225
City : ALEXANDRIA
State : LA
Zip : 71301-6890
Country : US
Telephone Number : 318-443-2338
Fax Number : 318-443-0258
Authorized Official
Title or Position : PRESIDENT, CLINICAL PSYCHOLOGIST
Name : DR. DANIEL JOHN LONOWSKI
Credential : PH.D.
Telephone Number : 318-443-2338
Provider Enumeration Date : 12/30/2006
Last Update Date : 06/25/2012

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