Provider Demographics
NPI:1093961450
Name:LEPAGE, DANA RENEE
Entity Type:Individual
Prefix:MISS
First Name:DANA
Middle Name:RENEE
Last Name:LEPAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3425
Mailing Address - Country:US
Mailing Address - Phone:585-248-5533
Mailing Address - Fax:
Practice Address - Street 1:530 CHURCH ST
Practice Address - Street 2:SUITE 1465
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1043
Practice Address - Country:US
Practice Address - Phone:734-764-9466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-16
Last Update Date:2008-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program