Provider Demographics
NPI:1982002820
Name:GOLDMAN, DANIEL (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6600 FRANCE AVE S
Mailing Address - Street 2:SUITE 670
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1805
Mailing Address - Country:US
Mailing Address - Phone:952-314-1926
Mailing Address - Fax:952-928-2000
Practice Address - Street 1:6600 FRANCE AVE S
Practice Address - Street 2:SUITE 670
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1805
Practice Address - Country:US
Practice Address - Phone:952-314-1926
Practice Address - Fax:952-928-2000
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP5759103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist