Provider Demographics
NPI:1174151732
Name:DANIELS, VINCENT MITCHEL
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:MITCHEL
Last Name:DANIELS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:VINCENT
Other - Middle Name:MITCHEL
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M ED, BCBA
Mailing Address - Street 1:29226 ORCHARD LAKE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3046
Mailing Address - Country:US
Mailing Address - Phone:866-960-9898
Mailing Address - Fax:866-960-9724
Practice Address - Street 1:29226 ORCHARD LAKE RD STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3046
Practice Address - Country:US
Practice Address - Phone:866-960-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician