Healthcare Provider Details

I. General information

NPI: 1972351286
Provider Name (Legal Business Name): GIFTED HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27500 FRANKLIN RD APT 802
SOUTHFIELD MI
48034-2327
US

IV. Provider business mailing address

27500 FRANKLIN RD APT 802
SOUTHFIELD MI
48034-2327
US

V. Phone/Fax

Practice location:
  • Phone: 313-702-9221
  • Fax:
Mailing address:
  • Phone: 313-702-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: BRITTANI NICOLE JONES
Title or Position: CEO
Credential:
Phone: 313-702-9221