Healthcare Provider Details

I. General information

NPI: 1609788371
Provider Name (Legal Business Name): MORGAN GIRVAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31201 DORCHESTER AVE
MADISON HEIGHTS MI
48071-1075
US

IV. Provider business mailing address

31201 DORCHESTER AVE
MADISON HEIGHTS MI
48071-1075
US

V. Phone/Fax

Practice location:
  • Phone: 248-589-9770
  • Fax: 248-589-2618
Mailing address:
  • Phone: 248-589-9770
  • Fax: 248-589-2618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101009066
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: