Individual
DEANNA O'DEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
640 GRISWOLD ST, SUITE 300, NORTHVILLE, MI 48167-1690
(248) 348-1100
(248) 348-3410
Mailing address
640 GRISWOLD ST, SUITE 300, NORTHVILLE, MI 48167-1690
(248) 348-1100
(248) 348-3410
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801033897
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801083183
GROUP NPI
MI
01
—
382695674
CLINIC TAX ID
MI
Enumeration date
12/20/2014
Last updated
12/20/2014
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