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General NPI Number Information
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NPI Number | 1942629167
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Entity Type | Individual
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Provider Name | DIANA POOL MA,MS, RSST, CHW
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1700 WATERMAN ST
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City | DETROIT
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State | MI
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Zip | 48209-2022
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Country | US
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Telephone | 138-413-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 16442 BRANDT ST
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City | ROMULUS
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State | MI
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Zip | 48174-3213
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Country | US
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Telephone | 734-578-2640
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | MI
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