Healthcare Provider Details

I. General information

NPI: 1467951236
Provider Name (Legal Business Name): ASHLEIGH LAUREN SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ASHMAN ST
MIDLAND MI
48640-4408
US

IV. Provider business mailing address

4075 S ISABELLA RD APT BB12
MOUNT PLEASANT MI
48858-8197
US

V. Phone/Fax

Practice location:
  • Phone: 989-633-9600
  • Fax:
Mailing address:
  • Phone: 269-275-7411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401016477
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: