Healthcare Provider Details

I. General information

NPI: 1114184470
Provider Name (Legal Business Name): DANIELLE SPRECHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33975 DEQUINDRE RD SUITE 5
TROY MI
48083-4649
US

IV. Provider business mailing address

33975 DEQUINDRE RD SUITE 5
TROY MI
48083-4649
US

V. Phone/Fax

Practice location:
  • Phone: 248-585-3239
  • Fax: 248-616-9759
Mailing address:
  • Phone: 248-585-3239
  • Fax: 248-616-9759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301007692
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: