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Individual

MR. MICHAEL L MCDANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
24 MALLARD CT, BECKLEY, WV 25801-3664
(304) 252-8409
(304) 252-8409
Mailing address
PO BOX 1025, BECKLEY, WV 25802-1025
(304) 252-8409
(304) 252-8409

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
552
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
552
LICENSE OF PSYCHOLOGY
WV
05
9204004000
WV
Enumeration date
07/07/2006
Last updated
01/22/2008
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