Healthcare Provider Details

I. General information

NPI: 1386848596
Provider Name (Legal Business Name): DANIEL TOWNSEND B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 LAWTON ST
DETROIT MI
48208-2500
US

IV. Provider business mailing address

22012 ROUGEWOOD DR
SOUTHFIELD MI
48034-5970
US

V. Phone/Fax

Practice location:
  • Phone: 313-361-6136
  • Fax:
Mailing address:
  • Phone: 248-223-9155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: