Provider Demographics
NPI:1104448992
Name:GOLDSCHMIDT, DANIEL BENJAMIN (MT-BC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BENJAMIN
Last Name:GOLDSCHMIDT
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 HOPEWOOD LN N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1147
Mailing Address - Country:US
Mailing Address - Phone:763-541-1168
Mailing Address - Fax:
Practice Address - Street 1:8617 HOPEWOOD LN N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1147
Practice Address - Country:US
Practice Address - Phone:763-541-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist