Doctor Name: | DANIEL V QUALLS |
NPI Number: | 1023047685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA LPC |
License Number: | 6401004824 |
Business Practice Address: | 923 S Beechtree St Suite 10 Grand Haven, MI - 494172306 |
Business Phone Number: | 6169351246 |
Business Fax Number: | |
Mailing Address: | Po Box 324, GRAND HAVEN |
State: | MI |
Postal Code: | 494170324 |
Phone Number: | 6169351246 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 04/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 6401004824 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |