Provider Demographics
NPI:1992992648
Name:PARRY, SHERYL ANNEMARIE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:ANNEMARIE
Last Name:PARRY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3823 AUTUMN VIEW LN NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7671
Mailing Address - Country:US
Mailing Address - Phone:770-318-4410
Mailing Address - Fax:
Practice Address - Street 1:3823 AUTUMN VIEW LN NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-7671
Practice Address - Country:US
Practice Address - Phone:770-318-4410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19126225X00000X
HIOT1071225X00000X
NY006579-1225X00000X
GAOT004639225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1992992648Medicaid
NY1992992648Medicaid