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Individual

MR. DANIEL G FENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
2501 CAPEHART RD, SUITE 2, OFFUTT AFB, NE 68113-1043
(402) 274-8018
Mailing address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7872
NE
1041C0700X
Clinical Social Worker
Primary
6467
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025559800
NE
Enumeration date
06/06/2008
Last updated
12/02/2021
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