Provider Demographics
NPI:1679208474
Name:MCDANIEL MOELLER, DAWN MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:MCDANIEL MOELLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:MOELLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1952 HERTFORD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-8961
Mailing Address - Country:US
Mailing Address - Phone:412-913-8207
Mailing Address - Fax:
Practice Address - Street 1:2957 RIDGE RD
Practice Address - Street 2:
Practice Address - City:SOUTH PARK
Practice Address - State:PA
Practice Address - Zip Code:15129-8824
Practice Address - Country:US
Practice Address - Phone:412-913-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006287L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical