Healthcare Provider Details
I. General information
NPI: 1235195231
Provider Name (Legal Business Name): ALISON ERIKA GILBERT AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 11/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1111 TENEYCK ST SUITE 200
JACKSON MI
49201-2461
US
IV. Provider business mailing address
DEPARTMENT 272801 PO BOX 67000
DETROIT MI
48267-0001
US
V. Phone/Fax
- Phone: 517-787-1468
- Fax: 517-787-0613
- Phone: 517-841-6913
- Fax: 517-841-6917
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 1601000038 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: