Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY-005293 | AZ |
NPI | 1063023836 |
---|---|
Provider Name | Daniel Wechsler |
First Address | Phoenix, AZ 85006-1823 |
Second Address | Phoenix, AZ 85006-1823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2020 |
Last Update Date | 13/08/2020 |