Provider Demographics
NPI:1194520148
Name:HAZLETT, DANIEL II (MA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HAZLETT
Suffix:II
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 KENNEBEC AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-1133
Mailing Address - Country:US
Mailing Address - Phone:330-410-4165
Mailing Address - Fax:
Practice Address - Street 1:3575 FOREST LAKE DR STE 100
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8115
Practice Address - Country:US
Practice Address - Phone:330-703-0105
Practice Address - Fax:234-294-5051
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.2500355106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist