Healthcare Provider Details

I. General information

NPI: 1114789161
Provider Name (Legal Business Name): DIANA MARIE FUCHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 PROFESSIONAL DR
ANN ARBOR MI
48104-5131
US

IV. Provider business mailing address

948 GREENWOOD AVE APT I
MONROE MI
48162-3059
US

V. Phone/Fax

Practice location:
  • Phone: 734-975-1602
  • Fax: 734-975-1604
Mailing address:
  • Phone: 737-343-6444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: