Individual
DR. STEPHEN DILLON FABICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
640 N OLD WOODWARD AVE, SUITE 201, BIRMINGHAM, MI 48009-3881
(248) 258-9288
(248) 258-5187
Mailing address
640 N OLD WOODWARD AVE, SUITE 201, BIRMINGHAM, MI 48009-3881
(248) 258-9288
(248) 258-5187
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301002475
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0 F3 4657
BCBS OF MICHIGAN
MI
01
—
0001011251
MHN (VENDOR #)
MI
01
—
56941
CIGNA BEHAVIORAL HEALTH
MI
01
—
99127
MANAGED HEALTH NETWORK
MI
Enumeration date
10/20/2005
Last updated
07/08/2007
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