Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | 14569 | TX |
N | 225C00000X | Rehabilitation Counselor | 30786 | TX |
NPI | 1013368547 |
---|---|
Provider Name | Daniel Flatley |
First Address | Dallas, TX 75246-1713 |
Second Address | Dallas, TX 75246-1713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 27/06/2016 |