=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841164274
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHELSEA GRIFFIN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2025
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 CRESTWOOD DR
-----------------------------------------------------
City | GROSSE POINTE SHORES
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48236-1107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-321-0207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50 CRESTWOOD DR
-----------------------------------------------------
City | GROSSE POINTE SHORES
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48236-1107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-321-0207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------