| Organization Name: | DANIEL BASS GOLDMAN |
| NPI Number: | 1114288487 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL BASS GOLDMAN (LICENSED PSYCHOLOGIST) |
| Mailing Address: | 425 Cross St #111 Punta Gorda |
| State: | FL US |
| Postal Code: | 339504877 |
| Phone Number: | 9412555489 |
| Fax Number: | 9412555481 |
| NPI Enumeration Date: | 06/04/2012 |
| NPI Last Update Date: | 06/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | PY8470 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |