Individual
DANIEL J MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD BCBA
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006470
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9932152
BCBS ID NUMBER
IL
Enumeration date
08/21/2006
Last updated
11/28/2012
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