Provider Demographics
NPI:1720482060
Name:HADDAD, DANIEL S
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:S
Last Name:HADDAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 E 65TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4421
Mailing Address - Country:US
Mailing Address - Phone:912-662-8705
Mailing Address - Fax:912-355-5954
Practice Address - Street 1:835 E 65TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4421
Practice Address - Country:US
Practice Address - Phone:912-662-8705
Practice Address - Fax:912-355-5954
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW005805101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor