Provider Demographics
NPI:1568561967
Name:ALDRIDGE, DAISY (MA)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19335 MARLOWE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1948
Mailing Address - Country:US
Mailing Address - Phone:133-575-1644
Mailing Address - Fax:
Practice Address - Street 1:20400 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-1222
Practice Address - Country:US
Practice Address - Phone:313-296-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical