Provider Demographics
NPI:1730158114
Name:DAUBNEY, JOHN (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:DAUBNEY
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 1:1655 W MARKET ST
Mailing Address - Street 2:SUITE 440
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7004
Mailing Address - Country:US
Mailing Address - Phone:330-867-7332
Mailing Address - Fax:330-867-9570
Practice Address - Street 1:1655 W MARKET ST
Practice Address - Street 2:SUITE 440
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7004
Practice Address - Country:US
Practice Address - Phone:330-867-7332
Practice Address - Fax:330-867-9570
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3062103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0547939Medicaid
OH0547939Medicaid
OHCP05581Medicare ID - Type Unspecified