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General NPI Number Information
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NPI Number | 1770242471
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Entity Type | Individual
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Provider Name | LEXI GIRD MS, TLLP
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Gender | Female
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 127 N WASHINGTON ST
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City | YPSILANTI
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State | MI
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Zip | 48197-2619
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Country | US
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Telephone | 734-682-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 1023 WASHTENAW RD APT 3
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City | YPSILANTI
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State | MI
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Zip | 48197-2161
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Country | US
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Telephone | 248-720-8961
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6362009437
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License Number State | MI
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