Individual
MRS. STACY LYNN DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
8142 HONEYTREE BLVD, BLDG. 61, CANTON, MI 48187-4109
(734) 414-1795
(734) 451-5410
Mailing address
563 ALLEN RD, LOT #1, MILAN, MI 48160-1516
(734) 323-1598
(734) 451-5410
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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