Provider Demographics
NPI:1659625457
Name:HIXON-BRENENSTALL, SHERI JOYCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:JOYCE
Last Name:HIXON-BRENENSTALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3016
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89702-3016
Mailing Address - Country:US
Mailing Address - Phone:775-335-6995
Mailing Address - Fax:775-392-0213
Practice Address - Street 1:309 E JOHN ST
Practice Address - Street 2:SUITE # 1
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3175
Practice Address - Country:US
Practice Address - Phone:775-335-6995
Practice Address - Fax:775-392-0213
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0668103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical