Individual
KELLY R DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1115 20TH ST, SUITE 205, HUNTINGTON, WV 25703-2071
(304) 691-1500
(304) 523-4358
Mailing address
1115 20TH ST, SUITE 205, HUNTINGTON, WV 25703-2071
(304) 691-1500
(304) 523-4358
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
809
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2372212
—
OH
05
—
9202134000
—
WV
Enumeration date
03/29/2006
Last updated
11/01/2012
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