Healthcare Provider Details

I. General information

NPI: 1205791423
Provider Name (Legal Business Name): ALLISON FOLIN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 BIDDLE AVE STE 2
WYANDOTTE MI
48192-4080
US

IV. Provider business mailing address

2070 BIDDLE AVE STE 2
WYANDOTTE MI
48192-4080
US

V. Phone/Fax

Practice location:
  • Phone: 734-671-6741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number5302415359
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: