Individual
DANIEL J SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, PC-TL
Contact information
Practice address
331 S ADAMS ST, GREEN BAY, WI 54301-4515
(920) 445-0170
(920) 445-0174
Mailing address
331 S ADAMS ST, GREEN BAY, WI 54301-4515
(920) 445-0170
(920) 445-0174
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
702-226
WI
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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