Individual
DR. LARRY E DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
2301 WRIGHTSBORO RD, AUGUSTA, GA 30904-6219
(706) 733-7029
(706) 733-1376
Mailing address
2301 WRIGHTSBORO RD, AUGUSTA, GA 30904-6219
(706) 733-7029
(706) 733-1376
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
831
SC
103T00000X
Psychologist
PSY002223
GA
103TB0200X
Cognitive & Behavioral Psychologist
PSY002223
GA
103TC0700X
Clinical Psychologist
PSY002223
GA
103TF0000X
Family Psychologist
PSY002223
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000801094C
—
GA
05
—
PS0268
—
SC
Enumeration date
07/26/2006
Last updated
12/01/2009
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