Provider Demographics
NPI:1275613283
Name:MONCRIEF, DANIELLE J (MA LLP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:J
Last Name:MONCRIEF
Suffix:
Gender:F
Credentials:MA LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36500 FORD RD
Mailing Address - Street 2:STE 112
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3769
Mailing Address - Country:US
Mailing Address - Phone:313-258-1809
Mailing Address - Fax:
Practice Address - Street 1:36500 FORD RD
Practice Address - Street 2:STE 112
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3769
Practice Address - Country:US
Practice Address - Phone:313-258-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013358101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor