Basic Information
| Provider Information | |||||||||
| NPI: | 1033244843 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ING | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | ANTONY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MA,LLP,CCHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 N 4TH AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481045503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342223581 | ||||||||
| FaxNumber: | 7349712487 | ||||||||
| Practice Location | |||||||||
| Address1: | 2140 E ELLSWORTH RD | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481082552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342223581 | ||||||||
| FaxNumber: | 7349712487 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2007 | ||||||||
| LastUpdateDate: | 06/04/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 6301010487 | MI | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.