Provider Demographics
NPI:1881867158
Name:MIGLIAZZO, DEBRA MARIE (MSW,LMSW,CAADC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:MIGLIAZZO
Suffix:
Gender:F
Credentials:MSW,LMSW,CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W UNIVERSITY DR STE 6D
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1975
Mailing Address - Country:US
Mailing Address - Phone:586-776-8885
Mailing Address - Fax:
Practice Address - Street 1:210 W UNIVERSITY DR STE 6D
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1975
Practice Address - Country:US
Practice Address - Phone:586-776-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI500430101YA0400X
MI68010799871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)