Provider Demographics
NPI:1477561173
Name:DANIELS, HOWARD B (PHD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:B
Last Name:DANIELS
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 1:1655 S DON ROSER DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4545
Mailing Address - Country:US
Mailing Address - Phone:575-523-2227
Mailing Address - Fax:
Practice Address - Street 1:1655 S DON ROSER DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4545
Practice Address - Country:US
Practice Address - Phone:575-523-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM342103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN9766Medicaid
NM201002229OtherPRESBYTERIAN HEALTH
NMNM01N207OtherBCBS & HMO OF NM
NMNM100650OtherVALUE OPTIONS OF NM
NMNM100650OtherVALUE OPTIONS OF NM