Provider Demographics
NPI:1326761149
Name:SHERMAN, KATELYN (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOODSTREAM CT
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4579
Mailing Address - Country:US
Mailing Address - Phone:314-292-9790
Mailing Address - Fax:
Practice Address - Street 1:101 WOODSTREAM CT
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4579
Practice Address - Country:US
Practice Address - Phone:407-228-3315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3097055171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach