Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PY7544 | FL |
NPI | 1003137530 |
---|---|
Provider Name | Dr. Daniel Philip |
First Address | Bay Pines, FL 33744-8200 |
Second Address | Bay Pines, FL 33744-8200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 29/11/2013 |