Doctor Name: | DANIEL J SIMON |
NPI Number: | 1174783823 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2680123 |
Business Practice Address: | 6717 Stone Glen Drive Middleton, WI - 53562 |
Business Phone Number: | 6088277100 |
Business Fax Number: | |
Mailing Address: | 6717 Stone Glen Drive, MIDDLETON |
State: | WI |
Postal Code: | 53562 |
Phone Number: | 6088277100 |
Fax Number: | |
NPI Enumeration Date: | 06/16/2008 |
NPI Last Update Date: | 06/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2680123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |