Provider Demographics
NPI:1871672964
Name:NEHLSEN-CANNARELLA, SANDRA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:NEHLSEN-CANNARELLA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3990 JOHN R ST
Mailing Address - Street 2:G518
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2018
Mailing Address - Country:US
Mailing Address - Phone:313-745-8090
Mailing Address - Fax:313-966-0934
Practice Address - Street 1:3990 JOHN R ST
Practice Address - Street 2:G518
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2018
Practice Address - Country:US
Practice Address - Phone:313-745-8090
Practice Address - Fax:313-966-0934
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics