Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 2-2661 | TX |
N | 103TC0700X | Clinical Psychologist | 2-2661 | TX |
Y | 102L00000X | Psychologist | 22661 | TX |
Y | 103T00000X | Psychologist | 22661 | TX |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 2-2661 | TX |
N | 103TA0700X | Adult Development & Aging Psychologist | 2-2661 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2-2661 | TX |
N | 103TF0200X | Forensic Psychologist | 2-2661 | TX |
NPI | 1558304543 |
---|---|
Provider Name | Mrs. Daneen A Milam |
First Address | San Antonio, TX 78209 |
Second Address | San Antonio, TX 78209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
033612501 | (05) | TX |