Provider Demographics
NPI:1275809956
Name:COULTER, SCHERRYL JENNICE
Entity Type:Individual
Prefix:MS
First Name:SCHERRYL
Middle Name:JENNICE
Last Name:COULTER
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 1:6908 FREEDOM AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135
Mailing Address - Country:US
Mailing Address - Phone:405-922-8586
Mailing Address - Fax:
Practice Address - Street 1:6908 FREEDOM AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-1908
Practice Address - Country:US
Practice Address - Phone:405-922-8586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health