Provider Demographics
NPI:1750818654
Name:HISEY, ALICIA KAY (PT, DPT, NCS, CBIS)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:KAY
Last Name:HISEY
Suffix:
Gender:F
Credentials:PT, DPT, NCS, CBIS
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:KAY
Other - Last Name:BRUMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, CBIS
Mailing Address - Street 1:7030 WHITMORE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8533
Mailing Address - Country:US
Mailing Address - Phone:248-486-3636
Mailing Address - Fax:810-355-4451
Practice Address - Street 1:7030 WHITMORE LAKE RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8533
Practice Address - Country:US
Practice Address - Phone:248-486-3636
Practice Address - Fax:810-355-4451
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist