Provider Demographics
NPI:1669286308
Name:DIONNE, EMILEY NICOLE
Entity type:Individual
Prefix:
First Name:EMILEY
Middle Name:NICOLE
Last Name:DIONNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6521
Mailing Address - Country:US
Mailing Address - Phone:978-314-5997
Mailing Address - Fax:
Practice Address - Street 1:1917 BEECHWOOD AVE
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-6521
Practice Address - Country:US
Practice Address - Phone:978-314-5997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32624104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker