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NPI Code Detail

MEDICARE: MR. DANIEL JOHN BUTLER ED.S.

MEDICARE: MR. DANIEL JOHN BUTLER ED.S.
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
1103TS0200XSchool Psychologist0813000169VA

General Provider Information

NPI Number : 1326545740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL JOHN BUTLER ED.S.
Provider Business Mailing Address
First Line : 202 N WASHINGTON AVE
Second Line :
City : PULASKI
State : VA
Zip : 24301-5022
Country : US
Telephone Number : 540-994-2500
Fax Number :
Provider Business Practice Location Address
First Line : 202 N WASHINGTON AVE
Second Line :
City : PULASKI
State : VA
Zip : 24301-5022
Country : US
Telephone Number : 540-994-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2018
Last Update Date : 04/11/2018

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