Healthcare Provider Details

I. General information

NPI: 1912838970
Provider Name (Legal Business Name): MAYA LOUISE CHAPPELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 REGENCY PARK DR
GRAND BLANC MI
48439-2559
US

IV. Provider business mailing address

3442 PRIMARY ST
AUBURN HILLS MI
48326-3245
US

V. Phone/Fax

Practice location:
  • Phone: 810-694-0600
  • Fax:
Mailing address:
  • Phone: 210-291-8092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number161001240
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: