Provider Demographics
NPI:1184777336
Name:O'LOUGHLIN, DANIEL DAVID (PHD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:DAVID
Last Name:O'LOUGHLIN
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 1:311 W SAN ANTONIO ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-3726
Mailing Address - Country:US
Mailing Address - Phone:830-997-0597
Mailing Address - Fax:830-997-0597
Practice Address - Street 1:311 W SAN ANTONIO ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-3726
Practice Address - Country:US
Practice Address - Phone:830-997-0597
Practice Address - Fax:830-997-0597
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24310103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling