Provider Demographics
NPI:1316372410
Name:CHRISTIAN, SHERYL NICHOLE (BS)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:NICHOLE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-2910
Mailing Address - Country:US
Mailing Address - Phone:203-787-2207
Mailing Address - Fax:203-773-7626
Practice Address - Street 1:501 LOMBARD ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-2910
Practice Address - Country:US
Practice Address - Phone:203-787-2207
Practice Address - Fax:203-773-7626
Is Sole Proprietor?:No
Enumeration Date:2013-09-08
Last Update Date:2013-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker