Provider Demographics
NPI:1316046220
Name:MUZZI, DENNIS J (LMSW)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:MUZZI
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 KNOWLES ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2767
Mailing Address - Country:US
Mailing Address - Phone:248-760-2672
Mailing Address - Fax:
Practice Address - Street 1:217 KNOWLES ST
Practice Address - Street 2:SUITE 260
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2767
Practice Address - Country:US
Practice Address - Phone:248-760-2672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801017027104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q26426180Medicare ID - Type Unspecified