Provider Demographics
NPI:1770712796
Name:MIDDLEBROOKS, DEANNA FAITH (MA/LLPC)
Entity type:Individual
Prefix:MISS
First Name:DEANNA
Middle Name:FAITH
Last Name:MIDDLEBROOKS
Suffix:
Gender:F
Credentials:MA/LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1443 W BOSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-1706
Mailing Address - Country:US
Mailing Address - Phone:313-869-6926
Mailing Address - Fax:
Practice Address - Street 1:4821 E MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48212-1730
Practice Address - Country:US
Practice Address - Phone:313-368-4800
Practice Address - Fax:313-368-4700
Is Sole Proprietor?:No
Enumeration Date:2009-07-12
Last Update Date:2009-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional