Provider Demographics
NPI:1881835759
Name:PALMER, DANIEL KEVIN (MHR, LMFT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:KEVIN
Last Name:PALMER
Suffix:
Gender:M
Credentials:MHR, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 N DONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2735
Mailing Address - Country:US
Mailing Address - Phone:405-495-7978
Mailing Address - Fax:405-787-2042
Practice Address - Street 1:7901 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-3107
Practice Address - Country:US
Practice Address - Phone:405-787-2042
Practice Address - Fax:405-787-2042
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK940106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist