| NPI | 1144384058 |
|---|---|
| Former Name | DANNY MITCHELL BAGLEY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA PSB#31955) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA PSB#31955) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2015-09-10 |