Individual
MICHAEL DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT SPEC.
Contact information
Practice address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000
Mailing address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
12/05/2018
Last updated
12/05/2018
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