Healthcare Provider Details

I. General information

NPI: 1205701943
Provider Name (Legal Business Name): GINA LOUISE HUFFERD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2399 E WALTON BLVD
AUBURN HILLS MI
48326-1955
US

IV. Provider business mailing address

328 WINCHESTER ST
SOUTH LYON MI
48178-2045
US

V. Phone/Fax

Practice location:
  • Phone: 248-475-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: