Provider Demographics
NPI:1649479023
Name:HASSEN, DEBRA ELAYNE (DC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ELAYNE
Last Name:HASSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14751 MANHATTAN PL
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1017
Mailing Address - Country:US
Mailing Address - Phone:248-632-6687
Mailing Address - Fax:
Practice Address - Street 1:G4150 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48529-1651
Practice Address - Country:US
Practice Address - Phone:810-742-1880
Practice Address - Fax:810-742-1883
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor