Basic Information
| Provider Information | |||||||||
| NPI: | 1356815971 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALE | ||||||||
| FirstName: | DANAYSHA | ||||||||
| MiddleName: | LASHAY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13213 E 14 MILE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483126302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485248801 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13213 E 14 MILE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485248801 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2019 | ||||||||
| LastUpdateDate: | 08/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.