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Individual

DANIEL ALLEN DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
519 S PARK ST, KALAMAZOO, MI 49007-5117
(269) 383-2294
Mailing address
54251 OLD MILL DR, ELKHART, IN 46514-4819
(517) 599-0085

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401013106
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1497005508
BEHAVIORAL HEALTH & SOCIAL SERVICES PROVIDER
MI
Enumeration date
09/17/2012
Last updated
12/01/2015
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