Provider Demographics
NPI:1154644060
Name:ROSENBLAD, SHERRY RENE (PHD, LPC-S)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:RENE
Last Name:ROSENBLAD
Suffix:
Gender:F
Credentials:PHD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 N WILLIS ST STE C
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79603-6993
Mailing Address - Country:US
Mailing Address - Phone:325-261-0137
Mailing Address - Fax:833-233-4071
Practice Address - Street 1:279 N WILLIS ST STE C
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-6993
Practice Address - Country:US
Practice Address - Phone:325-261-0137
Practice Address - Fax:833-233-4071
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63895101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional