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General NPI Number Information
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NPI Number | 1760956825
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Entity Type | Individual
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Provider Name | MARISSA DULCAMARO LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 25279 DALE ST
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City | ROSEVILLE
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State | MI
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Zip | 48066-3693
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Country | US
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Telephone | 586-764-9098
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Fax |
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Provider Business Mailing Address
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Address Line | 950 RAILROAD ST APT 325
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City | YPSILANTI
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State | MI
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Zip | 48197-3511
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Country | US
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Telephone | 586-764-9098
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801119981
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License Number State | MI
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