Individual
MR. DANIEL T ERIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
395 3RD ST, MANISTEE, MI 49660-1718
(877) 398-2013
Mailing address
1622 E SUGAR GROVE RD, SCOTTVILLE, MI 49454-9677
(231) 757-4592
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802065600
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802065600
MICHIGAN STATE LICENSE
MI
Enumeration date
02/11/2008
Last updated
02/11/2008
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