Provider Demographics
NPI:1114563830
Name:MENDEL, DANIEL (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:MENDEL
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 1:18672 SHAUNA MANOR DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2135
Mailing Address - Country:US
Mailing Address - Phone:347-266-8679
Mailing Address - Fax:
Practice Address - Street 1:18672 SHAUNA MANOR DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2135
Practice Address - Country:US
Practice Address - Phone:347-266-8679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3232106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty