Provider Demographics
NPI:1306087564
Name:DILLARD, ADRIENNE L (BA, BS, MBA)
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:L
Last Name:DILLARD
Suffix:
Gender:F
Credentials:BA, BS, MBA
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:L
Other - Last Name:ABNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19750 BURT RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-2078
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19750 BURT RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-2078
Practice Address - Country:US
Practice Address - Phone:313-977-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator