Healthcare Provider Details

I. General information

NPI: 1265822738
Provider Name (Legal Business Name): DANIELLE K RICE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17421 TELEGRAPH RD
DETROIT MI
48219-3165
US

IV. Provider business mailing address

17421 TELEGRAPH RD
DETROIT MI
48219-3165
US

V. Phone/Fax

Practice location:
  • Phone: 313-289-4113
  • Fax:
Mailing address:
  • Phone: 313-977-5004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801100277
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801104232
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: