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Individual

DR. DANIEL SEAGRAVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
MARTIN ARMY, 6600 VAN AALST BLVD, BLDG 9250, FORT MOORE, GA 31905
(505) 670-4484
Mailing address
MARTIN ARMY, 6600 VAN AALST BLVD, BLDG 9250, FORT MOORE, GA 31905
(505) 670-4484

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
685
NM
103TF0200X
Forensic Psychologist
Primary
685
NM

Other

Enumeration date
11/18/2012
Last updated
07/30/2024
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