Provider Demographics
NPI:1598233702
Name:WARING, DAKOTA RUSSELL
Entity Type:Individual
Prefix:
First Name:DAKOTA
Middle Name:RUSSELL
Last Name:WARING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48811 DENTON RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-2003
Mailing Address - Country:US
Mailing Address - Phone:517-877-0013
Mailing Address - Fax:
Practice Address - Street 1:48811 DENTON RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN TWP
Practice Address - State:MI
Practice Address - Zip Code:48111-2003
Practice Address - Country:US
Practice Address - Phone:517-877-0013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician