Provider Demographics
NPI:1669738795
Name:DAKROUB, DAVID SCOTT I (MS,LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SCOTT
Last Name:DAKROUB
Suffix:I
Gender:M
Credentials:MS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7090 SWAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:IRA
Mailing Address - State:MI
Mailing Address - Zip Code:48023-2533
Mailing Address - Country:US
Mailing Address - Phone:586-202-2732
Mailing Address - Fax:
Practice Address - Street 1:7090 SWAN CREEK RD
Practice Address - Street 2:
Practice Address - City:IRA
Practice Address - State:MI
Practice Address - Zip Code:48023-2533
Practice Address - Country:US
Practice Address - Phone:586-202-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional