Provider Demographics
NPI:1013348010
Name:DALEY, ANASTASIA
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N HURON ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2842
Mailing Address - Country:US
Mailing Address - Phone:734-480-0125
Mailing Address - Fax:734-480-0015
Practice Address - Street 1:300 N HURON ST
Practice Address - Street 2:SUITE 10
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2842
Practice Address - Country:US
Practice Address - Phone:734-480-0125
Practice Address - Fax:734-480-0015
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704206854163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health