Individual
MARK DIXON YANCY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5869 MARBLE DR, TROY, MI 48085-3967
(248) 943-7111
Mailing address
5869 MARBLE DR, TROY, MI 48085-3967
(248) 943-7111
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401016811
MI
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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