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General NPI Number Information
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NPI Number | 1114692894
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Entity Type | Individual
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Provider Name | DANIELA SHAMOON LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 35501 MOUND RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-4724
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Country | US
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Telephone | 248-727-7269
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Fax |
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Provider Business Mailing Address
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Address Line | 35542 BUXTON DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-4798
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Country | US
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Telephone | 586-306-3839
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801110885
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License Number State | MI
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