Provider Demographics
NPI:1841071263
Name:MCFEELY, DANIEL TYLER
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:TYLER
Last Name:MCFEELY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 S 2150 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84059-5594
Mailing Address - Country:US
Mailing Address - Phone:801-513-6607
Mailing Address - Fax:
Practice Address - Street 1:878 S 2150 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84059-5594
Practice Address - Country:US
Practice Address - Phone:801-513-6607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13171806-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health