Diesing, Mitzi Audra

Diesing, Mitzi Audra is an individual health care provider with primary practice located at 1200 N. West Ave. Suite 810, Jackson MI 49202-2179. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Diesing, Mitzi Audra can be contacted via phone (517) 300-3985.

Contact Information

Primary practice address
1200 N. West Ave. Suite 810 Jackson MI 49202-2179
Phone: (517) 300-3985
Fax: (517) 816-1267
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6801083573 Michigan
Behavioral Health & Social Service Providers / Social Worker 104100000X 6801083573 Michigan

Profile Details

NPI number 1073568374
LBN Legal business name Diesing, Mitzi Audra
Credentials MSW, LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Oct 20th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073568374 NPPES
Michigan Other 718982000 MAGELLAN STATE OF MI
Michigan Other 8008970860 MAGELLAN STATE OF MI

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