Healthcare Provider Details

I. General information

NPI: 1386551406
Provider Name (Legal Business Name): HALLIE GRIFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24220 ROSEWOOD ST
OAK PARK MI
48237-1735
US

IV. Provider business mailing address

1027 IRVING AVE
ROYAL OAK MI
48067-3310
US

V. Phone/Fax

Practice location:
  • Phone: 248-547-0880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101001804
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: