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Individual

DR. DALTON KILLIAN CONNALLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW, ACSW

Contact information

Practice address
3300 WASHTENAW AVE STE 260, ANN ARBOR, MI 48104-5184
(734) 277-7565
(734) 215-2363
Mailing address
3300 WASHTENAW AVE STE 260, ANN ARBOR, MI 48104-5184
(734) 277-7565
(734) 215-2363

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801095252
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
M17010
MI
Enumeration date
04/12/2013
Last updated
07/23/2021
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