Provider Demographics
NPI:1669343612
Name:THOMAS TRAVIS, SHARRYL (BLS INSTRUCTOR)
Entity type:Individual
Prefix:MRS
First Name:SHARRYL
Middle Name:
Last Name:THOMAS TRAVIS
Suffix:
Gender:F
Credentials:BLS INSTRUCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 GRAMATAN AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1826
Mailing Address - Country:US
Mailing Address - Phone:646-281-2234
Mailing Address - Fax:
Practice Address - Street 1:630 GRAMATAN AVE APT 1F
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-1826
Practice Address - Country:US
Practice Address - Phone:914-200-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25086625895171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach