Provider Demographics
NPI:1992167217
Name:PAUL, SHERRI L (CADC)
Entity type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:L
Last Name:PAUL
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-3906
Mailing Address - Country:US
Mailing Address - Phone:515-573-3931
Mailing Address - Fax:515-573-3950
Practice Address - Street 1:826 1ST AVE N
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-3906
Practice Address - Country:US
Practice Address - Phone:515-573-3931
Practice Address - Fax:515-573-3950
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15027171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator