Provider Demographics
NPI:1609207943
Name:HENKELMANN, SHERRY SUE
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:SUE
Last Name:HENKELMANN
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 1:7768-160TH ST.
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336
Mailing Address - Country:US
Mailing Address - Phone:320-420-7543
Mailing Address - Fax:
Practice Address - Street 1:7768-160TH ST.
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:MN
Practice Address - Zip Code:55336
Practice Address - Country:US
Practice Address - Phone:320-420-7543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child