Provider Demographics
NPI:1407358310
Name:DEBARGE, SHERI ANNE
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:ANNE
Last Name:DEBARGE
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 1:6548 N CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-7914
Mailing Address - Country:US
Mailing Address - Phone:352-322-9139
Mailing Address - Fax:
Practice Address - Street 1:6548 N CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-7914
Practice Address - Country:US
Practice Address - Phone:352-322-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician