Provider Demographics
NPI:1821368572
Name:MAR, DAN JOSEPH I
Entity Type:Individual
Prefix:MR
First Name:DAN
Middle Name:JOSEPH
Last Name:MAR
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HOLCOMBE LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-4223
Mailing Address - Country:US
Mailing Address - Phone:479-855-5744
Mailing Address - Fax:
Practice Address - Street 1:21 HOLCOMBE LN
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-4223
Practice Address - Country:US
Practice Address - Phone:479-855-5744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor