Provider Demographics
NPI:1437426848
Name:TAYLOR-BUTLER, SHERRY ANN (MS)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:ANN
Last Name:TAYLOR-BUTLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:NETTLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC INTERN
Mailing Address - Street 1:901 E 7TH CT
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3521
Mailing Address - Country:US
Mailing Address - Phone:850-960-7862
Mailing Address - Fax:850-215-7883
Practice Address - Street 1:901 E 7TH CT
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3521
Practice Address - Country:US
Practice Address - Phone:850-960-7862
Practice Address - Fax:850-215-7883
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH6747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health