Individual
MADISON MARIE INGERSOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1486 44TH ST SE STE 100, GRAND RAPIDS, MI 49508-4633
(616) 320-1096
Mailing address
3920 KIOWA CT SW, GRANDVILLE, MI 49418-1841
(616) 320-1096
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451023964
MI
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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