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General NPI Number Information
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NPI Number | 1114685724
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Entity Type | Individual
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Provider Name | DANIELLE NELSON
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Gender | Female
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 789 N CLARE AVE
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City | HARRISON
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State | MI
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Zip | 48625-8250
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Country | US
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Telephone | 989-390-4789
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Fax |
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Provider Business Mailing Address
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Address Line | 8158 N CLARE AVE UNIT A
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City | HARRISON
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State | MI
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Zip | 48625-8872
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Country | US
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Telephone | 989-390-4789
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | MI
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