Healthcare Provider Details

I. General information

NPI: 1275890139
Provider Name (Legal Business Name): DANIELE ANNETTE EILAND PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2012
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5031 PARK LAKE RD
EAST LANSING MI
48823-3835
US

IV. Provider business mailing address

302 S WAVERLY RD
LANSING MI
48917-3631
US

V. Phone/Fax

Practice location:
  • Phone: 517-332-0811
  • Fax: 517-332-4452
Mailing address:
  • Phone: 517-321-5900
  • Fax: 517-332-4452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: