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General NPI Number Information
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NPI Number | 1255115713
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Entity Type | Individual
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Provider Name | DANIEL GEORGE WAITES LLMSW
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Gender | Male
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 430 N LARCH ST
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City | LANSING
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State | MI
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Zip | 48912-1266
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Country | US
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Telephone | 423-329-9366
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Fax |
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Provider Business Mailing Address
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Address Line | 7733 MAPLE LN
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City | OWOSSO
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State | MI
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Zip | 48867-9209
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Country | US
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Telephone | 423-329-9366
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6851116194
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License Number State | MI
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