| Doctor Name: | MR. DAN R DEDLOFF |
| NPI Number: | 1205072311 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LPC |
| License Number: | 6401009570 |
| Business Practice Address: | 608 Wright Ave Alma, MI - 48801 |
| Business Phone Number: | 9894634971 |
| Business Fax Number: | 9894636515 |
| Mailing Address: | 608 Wright Ave, P.o. Box 69 ALMA |
| State: | MI |
| Postal Code: | 488010069 |
| Phone Number: | 9894634971 |
| Fax Number: | 9894636515 |
| NPI Enumeration Date: | 12/18/2008 |
| NPI Last Update Date: | 05/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401009570 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |