Provider Demographics
NPI:1508678392
Name:TORREBLANCA, DANIEL JOAQUIN III
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOAQUIN
Last Name:TORREBLANCA
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G4476 S DORT HWY
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48529-1806
Mailing Address - Country:US
Mailing Address - Phone:810-344-8082
Mailing Address - Fax:
Practice Address - Street 1:G4476 S DORT HWY
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48529-1806
Practice Address - Country:US
Practice Address - Phone:810-344-8082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician