Provider Demographics
NPI:1366289506
Name:WELLS, SHERREL ANN (MT MMP)
Entity type:Individual
Prefix:
First Name:SHERREL
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:MT MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 WASHTENAW AVE STE 22
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4524
Mailing Address - Country:US
Mailing Address - Phone:734-239-3344
Mailing Address - Fax:
Practice Address - Street 1:2350 WASHTENAW AVE
Practice Address - Street 2:SUITE 22
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104
Practice Address - Country:US
Practice Address - Phone:734-239-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7563225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty