Healthcare Provider Details

I. General information

NPI: 1013278969
Provider Name (Legal Business Name): INGRID SEKHON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W MONROE ST SUITE 500
JACKSON MI
49202-2079
US

IV. Provider business mailing address

950 W MONROE ST SUITE 500
JACKSON MI
49202-2079
US

V. Phone/Fax

Practice location:
  • Phone: 517-788-8330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801058003
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: