Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1053848580 |
---|---|
Provider Name | Ronald Daniels |
First Address | Pottstown, PA 19464-3146 |
Second Address | Pottstown, PA 19464-3146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2017 |
Last Update Date | 15/05/2017 |