Provider Demographics
NPI:1912190356
Name:FALARDEAU, DANA JOHANNA
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:JOHANNA
Last Name:FALARDEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:JOHANNA
Other - Last Name:ASIALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 W LAKE LANSING RD STE 500
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8473
Mailing Address - Country:US
Mailing Address - Phone:517-324-3278
Mailing Address - Fax:
Practice Address - Street 1:231 W LAKE LANSING RD STE 500
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8473
Practice Address - Country:US
Practice Address - Phone:517-324-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000475231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist