Individual
KEVIN DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACC
Contact information
Practice address
12010 LINWOOD ST, DETROIT, MI 48206-1108
(313) 867-1090
(313) 867-0706
Mailing address
15856 PARKSIDE ST, DETROIT, MI 48238-4104
(313) 334-2559
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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