Provider Demographics
NPI:1285843771
Name:EISER, ALAN SANFORD (PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:SANFORD
Last Name:EISER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E WILLIAM ST
Mailing Address - Street 2:SUITE 26D
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2441
Mailing Address - Country:US
Mailing Address - Phone:734-761-2772
Mailing Address - Fax:
Practice Address - Street 1:555 E WILLIAM ST
Practice Address - Street 2:SUITE 26D
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2441
Practice Address - Country:US
Practice Address - Phone:734-761-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006560103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical