Doctor Name: | ALICE SHERRON |
NPI Number: | 1447378997 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C. |
License Number: | 3804 |
Business Practice Address: | 111 E. Sterling Ave Buena Vista, CO - 81211 |
Business Phone Number: | 7193959454 |
Business Fax Number: | 7193959454 |
Mailing Address: | 34077 Surrey Ln, BUENA VISTA |
State: | CO |
Postal Code: | 812118607 |
Phone Number: | 7193959454 |
Fax Number: | 7193959454 |
NPI Enumeration Date: | 03/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3804 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |