Individual
MS. DENEQUA DIANE MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, TLLP
Contact information
Practice address
707 W. MILWAUKEE, DETROIT, MI 48202
(313) 833-2500
Mailing address
15001 KERCHEVAL AVE # 397, GROSSE POINTE PARK, MI 48230-1361
(586) 229-4024
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009487
MI
104100000X
Social Worker
1235413121
MI
Other
Enumeration date
10/10/2011
Last updated
12/02/2025
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