Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 4490 | AZ |
Y | 103TC0700X | Clinical Psychologist | 4490 | AZ |
NPI | 1003208166 |
---|---|
Provider Name | Dr. Daniel A Good |
First Address | North Las Vegas, NV 89031-2548 |
Second Address | North Las Vegas, NV 89031-2548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2015 |
Last Update Date | 07/07/2021 |