Healthcare Provider Details

I. General information

NPI: 1952236994
Provider Name (Legal Business Name): GABRIELLA ROSE RICHARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 HEREFORD RD
SALINE MI
48176-9225
US

IV. Provider business mailing address

6350 HEREFORD RD
SALINE MI
48176-9225
US

V. Phone/Fax

Practice location:
  • Phone: 734-904-7353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: