Healthcare Provider Details

I. General information

NPI: 1891617882
Provider Name (Legal Business Name): SHEILA K MARQUARDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 W STADIUM BLVD # 203
ANN ARBOR MI
48103-5285
US

IV. Provider business mailing address

10007 VFW RD
EATON RAPIDS MI
48827-9741
US

V. Phone/Fax

Practice location:
  • Phone: 734-212-2872
  • Fax:
Mailing address:
  • Phone: 734-212-2872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451024627
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: