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Shawna Davella Dietrick
Child Physical Disabilities Respite Care in Romulus, Michigan
NPI 1154955219

Shawna Davella Dietrick is a Child Physical Disabilities Respite Care based in Romulus, MI and is specialized in Respite Care, Physical Disabilities, Child. Shawna Davella Dietrick practices in Romulus, MI. The NPI Number for Shawna Davella Dietrick is 1154955219 and holds a License No. D362765135841 (Michigan).

The current practice location address for Shawna Davella Dietrick is 35675 Garner St, Romulus, MI and can be reached out via phone at 810-308-7991.

Location: 35675 Garner St, Romulus, MI, 48174-0083
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1154955219
Provider Name
Shawna Davella Dietrick
Credential
Provider Entity Type
Individual
Gender
Female
Address
35675 Garner St, Romulus, MI, 48174-0083
Phone Number
810-308-7991
Fax Number
Provider Enumeration Date
02/27/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
D362765135841 01 MI IDENTIFICATION
institution
Provider Business Practice Location Address Details
Address
35675 Garner St
City
Romulus
State
Michigan
Zip
48174-4129
Phone Number
810-308-7991
Fax Number
person
Provider Business Mailing Address Details
Address
35675 Garner St
City
Romulus
State
Michigan
Zip
48174-4129
Phone Number
810-308-7991
Fax Number
person
Provider's Taxonomy Details 1
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Physical Disabilities, Child
Taxonomy
385HR2065X
License No.
D362765135841 (Michigan)
Definition
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.
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