Provider Demographics
NPI:1396275426
Name:PERRY, SHEILA DIANE (CPRS, CSAC-A)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:DIANE
Last Name:PERRY
Suffix:
Gender:F
Credentials:CPRS, CSAC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 WILLOMETT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2921
Mailing Address - Country:US
Mailing Address - Phone:804-307-2914
Mailing Address - Fax:
Practice Address - Street 1:604 WILLOMETT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2921
Practice Address - Country:US
Practice Address - Phone:804-307-2914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1777175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist