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NPI 1346621430

NPI 1346621430 : GEORJEANA DILLARD-PARKER LLMSW : AUBURN HILLA, MI

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General NPI Number Information
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    NPI Number           |    1346621430
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    Entity Type          |    Individual 
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    Provider Name        |    GEORJEANA DILLARD-PARKER LLMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/15/2015
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    Last Update Date     |    06/15/2015
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Provider Practice Location Address
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    Address Line         |    620 SHEFFIELD ROAD 
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    City                 |    AUBURN HILLA
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    State                |    MI
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    Zip                  |    48326
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    Country              |    US
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    Telephone            |    248-212-1923
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    620 SHEFFIELD RD 
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    City                 |    AUBURN HILLS
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    State                |    MI
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    Zip                  |    48326-3527
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    Country              |    US
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    Telephone            |    248-212-1923
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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       |    6801097812
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    6801097812
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    License Number State |    MI
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