Provider Demographics
NPI:1578451779
Name:DICKINSON, ERIN M (MS, RD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 FAIRLAWN TER
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2924
Mailing Address - Country:US
Mailing Address - Phone:248-792-1311
Mailing Address - Fax:
Practice Address - Street 1:49650 CHERRY HILL RD STE 120
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4850
Practice Address - Country:US
Practice Address - Phone:734-398-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered