Individual
MR. DANIEL DEAN COUSINS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, CSAC, IDP-AT
Contact information
Practice address
15617 US HIGHWAY 63, HAYWARD, WI 54843-4244
(715) 634-4673
(715) 634-4675
Mailing address
15617 US HIGHWAY 63, P.O. BOX 800, HAYWARD, WI 54843-4244
(715) 634-4673
(715) 634-4675
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15562-131
WI
Other
Enumeration date
10/26/2010
Last updated
12/19/2016
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