Provider Demographics
NPI:1083065767
Name:DIVERSIFIED EDUCATIONAL CONSULTING SERVICES
Entity Type:Organization
Organization Name:DIVERSIFIED EDUCATIONAL CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:248-470-7004
Mailing Address - Street 1:38086 LANTERN HILL CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2896
Mailing Address - Country:US
Mailing Address - Phone:248-470-7004
Mailing Address - Fax:248-848-9367
Practice Address - Street 1:38086 LANTERN HILL CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-2896
Practice Address - Country:US
Practice Address - Phone:248-470-7004
Practice Address - Fax:248-848-9367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI680109488252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency