Healthcare Provider Details

I. General information

NPI: 1285540443
Provider Name (Legal Business Name): TALIA DOLGIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 LIVERNOIS RD
TROY MI
48098-4777
US

IV. Provider business mailing address

10824 LUDLOW AVE
HUNTINGTON WOODS MI
48070-1555
US

V. Phone/Fax

Practice location:
  • Phone: 248-823-3300
  • Fax:
Mailing address:
  • Phone: 248-563-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101003674
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: