Provider Demographics
NPI:1093126765
Name:KACHUR, DANIEL TOBIAS (MA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:TOBIAS
Last Name:KACHUR
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15 NORTH FRANKLIN STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383
Mailing Address - Country:US
Mailing Address - Phone:219-462-4770
Mailing Address - Fax:219-464-8156
Practice Address - Street 1:15 NORTH FRANKLIN STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383
Practice Address - Country:US
Practice Address - Phone:219-462-4770
Practice Address - Fax:219-464-8156
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging