Provider Demographics
NPI:1952491185
Name:DANIEL, MOLLY QUINN (PSYD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:QUINN
Last Name:DANIEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:QUINN
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4401 WESTOWN PKWY STE 109
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6721
Mailing Address - Country:US
Mailing Address - Phone:515-225-6653
Mailing Address - Fax:
Practice Address - Street 1:4401 WESTOWN PKWY STE 109
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6721
Practice Address - Country:US
Practice Address - Phone:515-225-6653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001090103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical