Individual provider · Type 1 NPI
Shawna Davella Dietrick
Child Physical Disabilities Respite Care · Romulus, MI
NPI number
1154955219
Active
Practice location
35675 Garner St
Romulus, MI 48174-4129
Mailing address
PO Box 74083
Romulus, MI 48174-0083
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child Physical Disabilities Respite Care Primary | 385HR2065X | D362765135841 (MI) |
Child Physical Disabilities Respite Care: A facility or distinct part of a facility that providers short term, residential care to children, diagnosed with complex or profound disabilities as respite for the regular caregivers.
2 other providers at this address
About NPI 1154955219
Shawna Davella Dietrick's National Provider Identifier is 1154955219, issued on Feb 27, 2020. The primary taxonomy on file is Child Physical Disabilities Respite Care (385HR2065X), and the practice location is in Romulus, MI. The record was last updated on Feb 27, 2020.