Provider Demographics
NPI:1063036838
Name:ROLSTON, SHERIL AMILIA
Entity type:Individual
Prefix:
First Name:SHERIL
Middle Name:AMILIA
Last Name:ROLSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5286 W JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:WEIDMAN
Mailing Address - State:MI
Mailing Address - Zip Code:48893-9637
Mailing Address - Country:US
Mailing Address - Phone:913-787-1026
Mailing Address - Fax:
Practice Address - Street 1:3365 FREELAND RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9778
Practice Address - Country:US
Practice Address - Phone:989-704-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program