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General NPI Number Information
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NPI Number | 1013774546
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Entity Type | Individual
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Provider Name | TRICIA DIANN DANIELS CLINICAL SPECIALIST
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 419 N MLK BLVD
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City | LANSING
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State | MI
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Zip | 48915-1856
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Country | US
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Telephone | 517-887-0226
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Fax | 517-887-8121
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Provider Business Mailing Address
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Address Line | 1504 FOREST HILLS DR
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City | OKEMOS
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State | MI
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Zip | 48864-2918
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Country | US
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Telephone | 517-648-3381
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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