Provider Demographics
NPI:1104643485
Name:SFERRA, MICHALE (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHALE
Middle Name:
Last Name:SFERRA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 BRIARCREST DR STE 24
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2769
Mailing Address - Country:US
Mailing Address - Phone:979-436-1956
Mailing Address - Fax:979-846-8070
Practice Address - Street 1:1737 BRIARCREST DR STE 24
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2769
Practice Address - Country:US
Practice Address - Phone:979-436-1956
Practice Address - Fax:979-846-8070
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39585103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist