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General NPI Number Information
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NPI Number | 1225463367
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Entity Type | Individual
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Provider Name | NICOLE ERINN DEKKER LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 40 E FERRY ST
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City | DETROIT
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State | MI
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Zip | 48202-3802
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Country | US
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Telephone | 734-785-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 870 NEW YORK AVE
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City | LINCOLN PARK
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State | MI
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Zip | 48146-3155
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Country | US
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Telephone | 313-587-7428
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6802087853
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License Number State | MI
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