Basic Information
| Provider Information | |||||||||
| NPI: | 1396998258 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIGUEREDO-LEAL | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | MAURICIO | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | TLLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30850 W 9 MILE RD | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483364202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482028491 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1424 E 11 MILE RD | ||||||||
| Address2: | |||||||||
| City: | ROYAL OAK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480672026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485484044 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2008 | ||||||||
| LastUpdateDate: | 10/23/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | L1409340 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.