Provider Demographics
NPI:1679970446
Name:DICKSON, TIMZETTA A (LLMSW)
Entity type:Individual
Prefix:
First Name:TIMZETTA
Middle Name:A
Last Name:DICKSON
Suffix:
Gender:
Credentials:LLMSW
Other - Prefix:
Other - First Name:TIMZETTA
Other - Middle Name:A
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:36995 MCKINNEY AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-1169
Mailing Address - Country:US
Mailing Address - Phone:313-600-1600
Mailing Address - Fax:
Practice Address - Street 1:36995 MCKINNEY AVE APT 104
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1169
Practice Address - Country:US
Practice Address - Phone:313-600-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-22
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other