Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1255412425 |
---|---|
Provider Name | Dr. Danny Howard Hall II |
First Address | Berkley, MI 48072-3010 |
Second Address | Detroit, MI 48201-1916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 10/06/2008 |