Provider Demographics
NPI:1477069367
Name:NOPPER, SHERRI LYNN (MS)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:LYNN
Last Name:NOPPER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:SHERRI
Other - Middle Name:LYNN
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11195 DEMILLE RD
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33868-6901
Mailing Address - Country:US
Mailing Address - Phone:863-287-2229
Mailing Address - Fax:
Practice Address - Street 1:1601 PARK CENTER DR STE 7
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5700
Practice Address - Country:US
Practice Address - Phone:407-730-3554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT2807101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health