Provider Demographics
NPI:1306345426
Name:DANIELS, SHERRIE (HAIR REPLACEMENT SPE)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:HAIR REPLACEMENT SPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 STATE ROAD 17 N
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2515
Mailing Address - Country:US
Mailing Address - Phone:863-385-4117
Mailing Address - Fax:
Practice Address - Street 1:2823 STATE ROAD 17 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2515
Practice Address - Country:US
Practice Address - Phone:863-385-4117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-04
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCL01861651744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management