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General NPI Number Information
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NPI Number | 1104753342
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Entity Type | Organization
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Legal Business Name | DARE TO BE LLC
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 137 VILLAGE WAY
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City | CANTON
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State | MI
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Zip | 48188-3449
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Country | US
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Telephone | 734-560-8534
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 223
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City | DEXTER
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State | MI
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Zip | 48130-0223
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Country | US
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Telephone | 734-560-8534
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | KAYLA LYNN DOUGLAS
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Credential | LMSW
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Telephone | 734-560-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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