Provider Demographics
NPI:1578897898
Name:RAKER, DANIEL K (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:K
Last Name:RAKER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3538
Mailing Address - Country:US
Mailing Address - Phone:970-275-2778
Mailing Address - Fax:970-609-0928
Practice Address - Street 1:917 MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3538
Practice Address - Country:US
Practice Address - Phone:970-275-2778
Practice Address - Fax:970-609-0928
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004966103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical