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Individual

MR. DANNY WHITEHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
211 4TH ST NE, STE 4, DEVILS LAKE, ND 58301-2479
(701) 662-8255
(701) 662-1739
Mailing address
PO BOX 883, DEVILS LAKE, ND 58301-0883
(701) 662-8255
(701) 662-1739

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4370
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
19260
ND
Enumeration date
05/24/2007
Last updated
10/02/2009
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