Provider Demographics
NPI:1831376201
Name:LONOWSKI, DANIEL JOHN (PHD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOHN
Last Name:LONOWSKI
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 1:4703 BAYOU COURT DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2564
Mailing Address - Country:US
Mailing Address - Phone:318-443-2338
Mailing Address - Fax:318-443-0258
Practice Address - Street 1:1605 MURRAY ST
Practice Address - Street 2:SUITE 225
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6890
Practice Address - Country:US
Practice Address - Phone:318-443-2338
Practice Address - Fax:318-443-0258
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA299103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA20589OtherBLUECROSS OF LA
LA20589OtherBLUECROSS OF LA
LAS24044Medicare UPIN