Healthcare Provider Details

I. General information

NPI: 1225946684
Provider Name (Legal Business Name): CATHY GIFFORD MA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27107 HALES ST
MADISON HEIGHTS MI
48071-3493
US

IV. Provider business mailing address

26524 JOHN R RD
MADISON HEIGHTS MI
48071-3612
US

V. Phone/Fax

Practice location:
  • Phone: 248-542-3414
  • Fax:
Mailing address:
  • Phone: 248-542-3414
  • Fax: 248-399-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101002028
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: