Healthcare Provider Details

I. General information

NPI: 1851179253
Provider Name (Legal Business Name): DANIELLE DAOUD OTD, OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 10/31/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 MACK AVE
DETROIT MI
48201
US

IV. Provider business mailing address

261 MACK AVE
DETROIT MI
48201
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-1100
  • Fax: 586-416-1560
Mailing address:
  • Phone: 313-745-1100
  • Fax: 586-416-1560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201013564
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: