Healthcare Provider Details

I. General information

NPI: 1194390864
Provider Name (Legal Business Name): NANCY ANN GRABILL LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 BYRON CENTER AVE SW
WYOMING MI
49519-4800
US

IV. Provider business mailing address

710 W 128TH ST
GRANT MI
49327-9660
US

V. Phone/Fax

Practice location:
  • Phone: 231-303-7090
  • Fax:
Mailing address:
  • Phone: 231-303-7090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401226111
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: