Provider Demographics
NPI:1275308587
Name:DEAN-HASSAN, TYRA (DONA)
Entity Type:Individual
Prefix:
First Name:TYRA
Middle Name:
Last Name:DEAN-HASSAN
Suffix:
Gender:F
Credentials:DONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13719 23 MILE RD # 216
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-2907
Mailing Address - Country:US
Mailing Address - Phone:586-265-8466
Mailing Address - Fax:
Practice Address - Street 1:13719 23 MILE RD # 216
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-2907
Practice Address - Country:US
Practice Address - Phone:586-265-8466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula