Provider Demographics
NPI:1164742474
Name:SHAPERO, DANA MARYSE (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARYSE
Last Name:SHAPERO
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32841 MIDDLEBELT RD STE 405
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1771
Mailing Address - Country:US
Mailing Address - Phone:248-246-6767
Mailing Address - Fax:248-246-2247
Practice Address - Street 1:32841 MIDDLEBELT RD STE 405
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1771
Practice Address - Country:US
Practice Address - Phone:248-246-6767
Practice Address - Fax:248-246-2247
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015580103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent