Provider Demographics
NPI:1588087043
Name:TANKERSLEY, SHERRY ANN (PHD)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:TANKERSLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROSS CIR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1078
Mailing Address - Country:US
Mailing Address - Phone:845-483-3814
Mailing Address - Fax:
Practice Address - Street 1:10 ROSS CIR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1078
Practice Address - Country:US
Practice Address - Phone:845-335-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021029103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist