Provider Demographics
NPI:1609247162
Name:RISI, DONNA M (CPPS)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:RISI
Suffix:
Gender:F
Credentials:CPPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14384 SUNSET ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-4364
Mailing Address - Country:US
Mailing Address - Phone:734-679-0502
Mailing Address - Fax:
Practice Address - Street 1:14384 SUNSET ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-4364
Practice Address - Country:US
Practice Address - Phone:734-679-0502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist