Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3499 | AZ |
NPI | 1114940319 |
---|---|
Provider Name | Dr. Daniel Newton Short |
First Address | Scottsdale, AZ 85260-5145 |
Second Address | Scottsdale, AZ 85260-5145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 07/05/2012 |