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General NPI Number Information
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NPI Number | 1083882625
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Entity Type | Individual
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Provider Name | LUEVA DIXON M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 950 E MAPLE RD SUITE 214
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6408
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Country | US
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Telephone | 248-540-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 590 WALLACE ST
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City | BIRMINGHAM
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State | MI
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Zip | 48009-1605
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Country | US
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Telephone | 248-540-7217
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Fax | 248-593-5756
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801015411
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License Number State | MI
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