Provider Demographics
NPI:1396359147
Name:SEARY, SHERLEEN
Entity Type:Individual
Prefix:
First Name:SHERLEEN
Middle Name:
Last Name:SEARY
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 1:1314 NORTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4509
Mailing Address - Country:US
Mailing Address - Phone:407-342-4220
Mailing Address - Fax:
Practice Address - Street 1:151 W CHURCH AVE
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4105
Practice Address - Country:US
Practice Address - Phone:407-342-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician