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NPI Code Detail

MEDICARE: MRS. DANIELLE BOVEE DOMZALSKI LLBSW, QMRP

MEDICARE: MRS. DANIELLE BOVEE DOMZALSKI LLBSW, QMRP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker6802087318MI

General Provider Information

NPI Number : 1871856153
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANIELLE BOVEE DOMZALSKI LLBSW, QMRP
Provider Business Mailing Address
First Line : 622 E GRAND RIVER AVE
Second Line :
City : HOWELL
State : MI
Zip : 48843-2329
Country : US
Telephone Number : 517-548-0081
Fax Number : 517-546-1300
Provider Business Practice Location Address
First Line : 622 E GRAND RIVER AVE
Second Line :
City : HOWELL
State : MI
Zip : 48843-2329
Country : US
Telephone Number : 517-548-0081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2012
Last Update Date : 12/09/2013

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Directions to “ MRS. DANIELLE BOVEE DOMZALSKI LLBSW, QMRP” Practice Location

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