Provider Demographics
NPI:1770868184
Name:DYESS, DREANNA RACHELLE (HHA)
Entity type:Individual
Prefix:MRS
First Name:DREANNA
Middle Name:RACHELLE
Last Name:DYESS
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12094 COLUMBIA
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2576
Mailing Address - Country:US
Mailing Address - Phone:313-937-8375
Mailing Address - Fax:
Practice Address - Street 1:7789 WILLIAMSON LN
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-8523
Practice Address - Country:US
Practice Address - Phone:614-834-3615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2953406OtherIP NUMBER