Provider Demographics
NPI:1982234381
Name:DIPACE, ALESSANDRA VITA MARIA
Entity Type:Individual
Prefix:MISS
First Name:ALESSANDRA
Middle Name:VITA MARIA
Last Name:DIPACE
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 1:8466 37 MILE RD
Mailing Address - Street 2:
Mailing Address - City:BRUCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48065-1351
Mailing Address - Country:US
Mailing Address - Phone:586-929-1201
Mailing Address - Fax:
Practice Address - Street 1:49970 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-1347
Practice Address - Country:US
Practice Address - Phone:586-991-6596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant