Provider Demographics
NPI:1831468867
Name:SECOR, DANIEL CARL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CARL
Last Name:SECOR
Suffix:
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 1:33A MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-1515
Mailing Address - Country:US
Mailing Address - Phone:508-341-7061
Mailing Address - Fax:
Practice Address - Street 1:21 PHEASANT COURT
Practice Address - Street 2:AUBURN YOUTH AND FAMILY SERVICES
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501
Practice Address - Country:US
Practice Address - Phone:508-832-5707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health