Provider Demographics
NPI:1679297626
Name:NEAL, TIRANA SYNON
Entity type:Individual
Prefix:
First Name:TIRANA
Middle Name:SYNON
Last Name:NEAL
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 1:1423 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-2321
Mailing Address - Country:US
Mailing Address - Phone:313-825-2435
Mailing Address - Fax:
Practice Address - Street 1:1423 FIELD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-2321
Practice Address - Country:US
Practice Address - Phone:313-825-2435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist