Provider Demographics
NPI:1558402305
Name:HADLEY, DANIEL THOMAS (MA)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:THOMAS
Last Name:HADLEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 WATKINS LN
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7947
Mailing Address - Country:US
Mailing Address - Phone:269-962-5035
Mailing Address - Fax:
Practice Address - Street 1:714 MAIN ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4568
Practice Address - Country:US
Practice Address - Phone:269-979-3881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist