Healthcare Provider Details

I. General information

NPI: 1073647095
Provider Name (Legal Business Name): DANIEL JOHN KACHMAN ED. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2791 GUELPH CT
NORTH BRANCH MI
48461-7927
US

IV. Provider business mailing address

2791 GUELPH CT
NORTH BRANCH MI
48461-7927
US

V. Phone/Fax

Practice location:
  • Phone: 810-664-4363
  • Fax:
Mailing address:
  • Phone: 810-664-4363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301002139
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: