Provider Demographics
NPI:1790900934
Name:DICCION, ROMEO A II (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:ROMEO
Middle Name:A
Last Name:DICCION
Suffix:II
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9131
Mailing Address - Country:US
Mailing Address - Phone:734-944-3306
Mailing Address - Fax:
Practice Address - Street 1:2008 HOGBACK RD
Practice Address - Street 2:SUITE 8
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9768
Practice Address - Country:US
Practice Address - Phone:734-786-4900
Practice Address - Fax:734-786-8051
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401001517101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional