Provider Information for 1336628650
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STEPHANIE BRIONNA DIXON LMSW
Sex: Female
NPI: 1336628650
Last Updated: 2023-01-19
Certification Date: 2023-01-19
Certification Date: 2023-01-19
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1336628650 | ||||||||
| Enumeration Date | 2018-08-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 42483 CLINTON PLACE DR CLINTON TOWNSHIP, MI 48038-1634 United States Phone: 248-671-3349 | Fax: | ||||||||
| Primary Practice Address | 42483 CLINTON PLACE DR CLINTON TOWNSHIP, MI 48038-1634 United States Phone: 313-467-4293 | Fax: | ||||||||
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