Provider Demographics
NPI:1649900234
Name:GRASSO, DANIEL ALFONSO (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ALFONSO
Last Name:GRASSO
Suffix:
Gender:M
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1429 FLUSHING RD STE C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2228
Mailing Address - Country:US
Mailing Address - Phone:810-380-5060
Mailing Address - Fax:810-380-5065
Practice Address - Street 1:1429 FLUSHING RD STE C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-2228
Practice Address - Country:US
Practice Address - Phone:810-380-5060
Practice Address - Fax:810-380-5065
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704314788363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health