| Doctor Name: | SHERI LYNN PETRUSO |
| NPI Number: | 1598865446 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW |
| License Number: | 005052 |
| Business Practice Address: | 1600 Heritage Landing Suite 116 St Peters, MO - 63303 |
| Business Phone Number: | 6363451400 |
| Business Fax Number: | 6364413262 |
| Mailing Address: | 1600 Heritage Landing, Suite 116 ST PETERS |
| State: | MO |
| Postal Code: | 63303 |
| Phone Number: | 6363451400 |
| Fax Number: | 6364413262 |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 04/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 005052 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |