Provider Demographics
NPI:1972769891
Name:WATKINS, DANIEL K (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:K
Last Name:WATKINS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 W CENTRAL AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606
Mailing Address - Country:US
Mailing Address - Phone:419-279-3035
Mailing Address - Fax:419-469-2351
Practice Address - Street 1:3450 W CENTRAL AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-279-3035
Practice Address - Fax:419-469-2351
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical