Healthcare Provider Details

I. General information

NPI: 1306384383
Provider Name (Legal Business Name): BRIANA GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 ANN ARBOR ROAD
JACKSON MI
49201
US

IV. Provider business mailing address

1656 BISHOP RD
SALINE MI
48176-9456
US

V. Phone/Fax

Practice location:
  • Phone: 517-764-2000
  • Fax:
Mailing address:
  • Phone: 734-216-2225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101005402
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: