Provider Demographics
NPI:1205968674
Name:OESTERWIND, DONALD J JR (CAC-1)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:J
Last Name:OESTERWIND
Suffix:JR
Gender:M
Credentials:CAC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 S MERRIMAN RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4951
Mailing Address - Country:US
Mailing Address - Phone:734-641-1141
Mailing Address - Fax:734-641-1142
Practice Address - Street 1:917 S MERRIMAN RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4951
Practice Address - Country:US
Practice Address - Phone:734-641-1141
Practice Address - Fax:734-641-1142
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-0122101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)