Provider Demographics
NPI:1013515923
Name:ALSENAD, SARAH
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:ALSENAD
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 1:16801 W OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2476
Mailing Address - Country:US
Mailing Address - Phone:313-848-4708
Mailing Address - Fax:
Practice Address - Street 1:16801 W OUTER DR
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2476
Practice Address - Country:US
Practice Address - Phone:313-848-4708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA425758018254OtherSTATE DRIVERS LICENSE