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Individual

DANIEL CERVANTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
720 N MARR RD, COLUMBUS, IN 47201-6660
(812) 314-3400
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39004284A
IN
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor

Other

Enumeration date
01/04/2018
Last updated
10/25/2022
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