Individual
DR. THOMAS L. DANIELS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6510 GRAND TETON PLZ, SUITE 406, MADISON, WI 53719-1029
(608) 833-9290
(608) 833-9691
Mailing address
6510 GRAND TETON PLZ, SUITE 406, MADISON, WI 53719-1029
(608) 833-9290
(608) 833-9691
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2007-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10617
DEAN HEALTH PLAN
WI
05
—
39649600
—
WI
Enumeration date
05/20/2006
Last updated
07/08/2007
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