Healthcare Provider Details

I. General information

NPI: 1447274097
Provider Name (Legal Business Name): JOANNE DINUNZIO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNE DINUNZIO 6801082542

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 NORTH GROESBECK
MT. CLEMENS MI
48043
US

IV. Provider business mailing address

19611 E 8 MILE RD
SAINT CLAIR SHORES MI
48080-1655
US

V. Phone/Fax

Practice location:
  • Phone: 586-627-0024
  • Fax: 586-627-0027
Mailing address:
  • Phone: 586-541-3550
  • Fax: 586-204-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801082542
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: