Individual
DR. DANIEL DEAN FACHTING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
301 E 4TH ST, CLARE, MI 48617-1547
(989) 386-8166
(989) 386-8166
Mailing address
301 E 4TH ST, CLARE, MI 48617-1547
(989) 386-8166
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301008802
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11275836
CAQH
MI
01
—
251479000
MAGELLAN PIN
MI
01
—
680A810140
BLUE CROSS BLUE SHIELD PI
MI
Enumeration date
12/26/2006
Last updated
07/08/2007
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