Provider Demographics
NPI:1114046794
Name:SCHAEFER, DANIEL A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 W SOUTH BOUNDARY ST
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5200
Mailing Address - Country:US
Mailing Address - Phone:419-874-3201
Mailing Address - Fax:419-874-1989
Practice Address - Street 1:836 W SOUTH BOUNDARY ST
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5200
Practice Address - Country:US
Practice Address - Phone:419-874-3201
Practice Address - Fax:419-874-1989
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5684103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist