Provider Demographics
NPI:1033519087
Name:DIXSON-HASKETT, JOYCE
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:DIXSON-HASKETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:DIXSON-HASKETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:23597 PLUMBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3249
Mailing Address - Country:US
Mailing Address - Phone:248-403-9872
Mailing Address - Fax:
Practice Address - Street 1:DAYLILY HEALTH LLC
Practice Address - Street 2:26080 WOODWARD AVE.
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-4806
Practice Address - Country:US
Practice Address - Phone:248-556-4556
Practice Address - Fax:248-556-4557
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010860371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical