Provider Demographics
NPI:1326323015
Name:FERRELL, SHARIE DOUCET (MS,PT)
Entity Type:Individual
Prefix:
First Name:SHARIE
Middle Name:DOUCET
Last Name:FERRELL
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17220 DAWN CT
Mailing Address - Street 2:
Mailing Address - City:AMELIA COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23002-4891
Mailing Address - Country:US
Mailing Address - Phone:804-892-8333
Mailing Address - Fax:
Practice Address - Street 1:17220 DAWN CT
Practice Address - Street 2:
Practice Address - City:AMELIA COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23002-4891
Practice Address - Country:US
Practice Address - Phone:804-892-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist