Healthcare Provider Details

I. General information

NPI: 1336090059
Provider Name (Legal Business Name): ERIN M WHITEFORD LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2026
Last Update Date: 02/07/2026
Certification Date: 02/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3167 KALAMAZOO AVE SE STE 202
GRAND RAPIDS MI
49508-1475
US

IV. Provider business mailing address

1859 MILLBROOK ST SE
GRAND RAPIDS MI
49508-2620
US

V. Phone/Fax

Practice location:
  • Phone: 616-389-5166
  • Fax:
Mailing address:
  • Phone: 616-389-5166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number7501015645
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: