Provider Demographics
NPI:1629561337
Name:STARNES-PATTERSON, SHERIKA ILEAN (RBT MED)
Entity Type:Individual
Prefix:MRS
First Name:SHERIKA
Middle Name:ILEAN
Last Name:STARNES-PATTERSON
Suffix:
Gender:F
Credentials:RBT MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 N HARRIS CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38114-5011
Mailing Address - Country:US
Mailing Address - Phone:901-270-7357
Mailing Address - Fax:901-270-7357
Practice Address - Street 1:2940 N HARRIS CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38114-5011
Practice Address - Country:US
Practice Address - Phone:901-270-7357
Practice Address - Fax:901-270-7357
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16106S00000X
TNRBT-16-21344106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN105940882OtherDRIVERS LICENSE NUMBER