Provider Demographics
NPI:1972117240
Name:MCCRAY, SHERRI MARIE
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:MARIE
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FLORENCE HILL CT
Mailing Address - Street 2:
Mailing Address - City:BLACK JACK
Mailing Address - State:MO
Mailing Address - Zip Code:63033-7230
Mailing Address - Country:US
Mailing Address - Phone:314-477-1695
Mailing Address - Fax:
Practice Address - Street 1:4 FLORENCE HILL CT
Practice Address - Street 2:
Practice Address - City:BLACK JACK
Practice Address - State:MO
Practice Address - Zip Code:63033-7230
Practice Address - Country:US
Practice Address - Phone:314-477-1695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service