Provider Demographics
NPI:1417390485
Name:HALSTEAD, D. YARROW MARIE (MA, CPSS)
Entity Type:Individual
Prefix:MS
First Name:D. YARROW
Middle Name:MARIE
Last Name:HALSTEAD
Suffix:
Gender:F
Credentials:MA, CPSS
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:MARIE
Other - Last Name:HALSTEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CPSS
Mailing Address - Street 1:555 TOWNER ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5752
Mailing Address - Country:US
Mailing Address - Phone:734-544-3000
Mailing Address - Fax:734-544-6732
Practice Address - Street 1:2140 E ELLSWORTH RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2552
Practice Address - Country:US
Practice Address - Phone:734-222-9533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker