Provider Demographics
NPI:1497220156
Name:SHERWOOD, SHAUNTE T
Entity Type:Individual
Prefix:
First Name:SHAUNTE
Middle Name:T
Last Name:SHERWOOD
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 1:9665 W VILLA CHULA
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4335
Mailing Address - Country:US
Mailing Address - Phone:623-565-3553
Mailing Address - Fax:
Practice Address - Street 1:924 N COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-4108
Practice Address - Country:US
Practice Address - Phone:480-844-1653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional