MEDICARE: DANIEL MAUER, PHD., LLC

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

General Provider Information

NPI Number	:	1366162265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL MAUER, PHD., LLC

Provider Business Mailing Address
First Line	:	3200 NE 10TH ST APT 1
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3947
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 NE 10TH ST APT 1
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3947
Country	:	US
Telephone Number	:	410-746-6530
Fax Number	:

Authorized Official
Title or Position	:	PHD
Name	:	DANIEL MAUER
Credential	:
Telephone Number	:	410-746-6530

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	08/31/2022

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