Healthcare Provider Details

I. General information

NPI: 1316855737
Provider Name (Legal Business Name): DANIELLE SYLVIA GRAYSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE SYLVIA MAKI LLMSW

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N ELM ST
EWEN MI
49925
US

IV. Provider business mailing address

131 OLSON RD
WAKEFIELD MI
49968-9533
US

V. Phone/Fax

Practice location:
  • Phone: 906-364-1967
  • Fax:
Mailing address:
  • Phone: 906-364-1967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6851114163
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: