Healthcare Provider Details

I. General information

NPI: 1770912552
Provider Name (Legal Business Name): DANIEL LEE FINSTROM M.A; CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17111 G DR N
MARSHALL MI
49068-9621
US

IV. Provider business mailing address

17111 G DR N
MARSHALL MI
49068-9641
US

V. Phone/Fax

Practice location:
  • Phone: 269-998-6777
  • Fax:
Mailing address:
  • Phone: 269-998-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number09149417
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: