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General NPI Number Information
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NPI Number | 1629972666
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Entity Type | Individual
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Provider Name | TERRELL GRIFFIN
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Gender | Male
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 5807 W MAPLE RD STE 171
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4483
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Country | US
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Telephone | 248-633-8576
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Fax |
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Provider Business Mailing Address
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Address Line | 6877 ARLENE CT
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City | ROMULUS
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State | MI
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Zip | 48174-4020
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Country | US
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Telephone | 313-799-5792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704375746
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License Number State | MI
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