Healthcare Provider Details

I. General information

NPI: 1780800714
Provider Name (Legal Business Name): DEBORAH J GILES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 E WEST MAPLE RD # D405
COMMERCE TOWNSHIP MI
48390-3801
US

IV. Provider business mailing address

2864 ADLAKE DR
WATERFORD MI
48329-2500
US

V. Phone/Fax

Practice location:
  • Phone: 248-668-0922
  • Fax: 248-668-0924
Mailing address:
  • Phone: 248-668-0922
  • Fax: 248-668-0924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6801059833
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: