Individual
MS. VANESSA D MANNNIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW/CAC-M
Contact information
Practice address
3737 LAWTON ST, DETROIT, MI 48208-2500
(313) 361-6136
Mailing address
31097 WARREN RD APT 108, WESTLAND, MI 48185-2964
(734) 261-5106
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
381737643
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811094998
—
MI
Enumeration date
03/19/2007
Last updated
08/28/2008
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