Individual
DANIELLE MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9315 TELEGRAPH RD, REDFORD, MI 48239-1260
(313) 450-4500
Mailing address
9315 TELEGRAPH RD, REDFORD, MI 48239-1260
(313) 450-4500
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382833497
—
MI
Enumeration date
01/08/2018
Last updated
01/08/2018
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