Basic Information
| Provider Information | |||||||||
| NPI: | 1639549033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEES | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22201 FRAZHO ST | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480812475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485252675 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22708 HARPER AVE | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5864452210 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2015 | ||||||||
| LastUpdateDate: | 07/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801099497 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.