Healthcare Provider Details

I. General information

NPI: 1164046686
Provider Name (Legal Business Name): ABIGAIL GRIFFIN OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5191 ROSEWOOD DR
TRAVERSE CITY MI
49685-9137
US

IV. Provider business mailing address

235 WEALTHY ST SE
GRAND RAPIDS MI
49503-5247
US

V. Phone/Fax

Practice location:
  • Phone: 231-946-1979
  • Fax: 231-946-1984
Mailing address:
  • Phone: 616-840-8000
  • Fax: 616-840-9690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2897
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201010567
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: