Provider Demographics
NPI:1518008671
Name:ALPERN, DANA M (PHD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:ALPERN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 WILLOW TREE PL
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1322
Mailing Address - Country:US
Mailing Address - Phone:313-881-0048
Mailing Address - Fax:
Practice Address - Street 1:15450 E JEFFERSON AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-2028
Practice Address - Country:US
Practice Address - Phone:313-821-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006077103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist