Provider Demographics
NPI:1225342280
Name:DAVIS, DANIEL P (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:DAVIS
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 1:7601 GANSER WAY
Mailing Address - Street 2:2ND FLOOR SUITE
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2074
Mailing Address - Country:US
Mailing Address - Phone:608-609-5277
Mailing Address - Fax:
Practice Address - Street 1:7601 GANSER WAY
Practice Address - Street 2:2ND FLOOR SUITE
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2074
Practice Address - Country:US
Practice Address - Phone:608-609-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2806-57103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist