Provider Demographics
NPI:1194870089
Name:HENSLEY, SHERYL L (LMT, TTT)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:L
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:LMT, TTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CROSS RDG
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4337
Mailing Address - Country:US
Mailing Address - Phone:864-593-0480
Mailing Address - Fax:
Practice Address - Street 1:250 S PLEASANTBURG DR
Practice Address - Street 2:SUITE 107
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2522
Practice Address - Country:US
Practice Address - Phone:864-593-0480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4507174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist