Basic Information
Provider Information
NPI: 1861984874
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALBRIGHT
FirstName: DANA
MiddleName: KATE
NamePrefix:  
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MAY
OtherFirstName: DANA
OtherMiddleName: K
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3621 S STATE ST
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481081633
CountryCode: US
TelephoneNumber: 7346475299
FaxNumber:  
Practice Location
Address1: 1500 E MEDICAL CENTER DR
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481095000
CountryCode: US
TelephoneNumber: 7349364000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2018
LastUpdateDate: 11/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X6301016866MIN Behavioral Health & Social Service ProvidersPsychologist 
103TC0700X6301016866MIN Behavioral Health & Social Service ProvidersPsychologistClinical
103TC2200X6301016866MIY Behavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent

No ID Information.


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