Individual
MS. DARCIE ANN DIBASIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5600 W MAPLE RD STE B204, WEST BLOOMFIELD, MI 48322-3707
(586) 465-1482
Mailing address
18198 MILLAR RD, CLINTON TOWNSHIP, MI 48036-2088
(586) 465-1482
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704249095
MI
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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