Provider Demographics
NPI:1467015800
Name:SIMPSON, DANIEL STUART (BCBA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:STUART
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24555 HALLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-1667
Mailing Address - Country:US
Mailing Address - Phone:248-238-9772
Mailing Address - Fax:844-270-6477
Practice Address - Street 1:24555 HALLWOOD CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-1667
Practice Address - Country:US
Practice Address - Phone:248-238-9772
Practice Address - Fax:844-270-6477
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-19-35088103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst