Provider Demographics
NPI:1104665256
Name:HARTLAUER, DANIEL (BHP)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HARTLAUER
Suffix:
Gender:M
Credentials:BHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 N JAY ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-4479
Mailing Address - Country:US
Mailing Address - Phone:623-687-8053
Mailing Address - Fax:
Practice Address - Street 1:3280 S COUNTRY CLUB WAY
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4065
Practice Address - Country:US
Practice Address - Phone:602-285-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-21965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health