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Individual

MRS. BETHANY DALESSANDRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AG-ACNP

Contact information

Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-6000
Mailing address
3314 RAYMOND AVE, DEARBORN, MI 48124-4384
(313) 492-6600

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
4704250292
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704250292
MI

Other

Enumeration date
04/28/2018
Last updated
01/24/2019
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