Healthcare Provider Details

I. General information

NPI: 1225499734
Provider Name (Legal Business Name): AUDREY DUNBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 N MILFORD RD
HIGHLAND MI
48357-3815
US

IV. Provider business mailing address

2029 N MILFORD RD
HIGHLAND MI
48357-3815
US

V. Phone/Fax

Practice location:
  • Phone: 248-676-8349
  • Fax:
Mailing address:
  • Phone: 248-676-8349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101004723
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: