Healthcare Provider Details

I. General information

NPI: 1235452392
Provider Name (Legal Business Name): DAVID V HAUXWELL LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 PROSPECT AVE
CARO MI
48723-9288
US

IV. Provider business mailing address

323 N STATE ST
CARO MI
48723-1537
US

V. Phone/Fax

Practice location:
  • Phone: 989-673-6191
  • Fax: 989-672-3443
Mailing address:
  • Phone: 989-673-6191
  • Fax: 989-672-3443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801035135
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: