Provider Demographics
NPI:1336609320
Name:DOZIER, EMILY (BPA, MPA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DOZIER
Suffix:
Gender:F
Credentials:BPA, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 CADILLAC SQ FL 30
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-2844
Mailing Address - Country:US
Mailing Address - Phone:313-333-5337
Mailing Address - Fax:313-962-6740
Practice Address - Street 1:65 CADILLAC SQ FL 30
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-2844
Practice Address - Country:US
Practice Address - Phone:313-333-5337
Practice Address - Fax:313-962-6740
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI190325000169Medicaid