Provider Demographics
NPI:1932588134
Name:PUCHALA, DANIEL JAMES (MA, LGPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JAMES
Last Name:PUCHALA
Suffix:
Gender:M
Credentials:MA, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 THOMAS JOHNSON DR STE A
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 THOMAS JOHNSON DR STE A
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4371
Practice Address - Country:US
Practice Address - Phone:240-575-9688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional