Provider Demographics
NPI:1760957468
Name:MILLER, SHERRY LEIGH (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LEIGH
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 RUMFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3872
Mailing Address - Country:US
Mailing Address - Phone:781-894-4325
Mailing Address - Fax:781-894-1195
Practice Address - Street 1:C/O CHILDREN'S CHARTER
Practice Address - Street 2:77 RUMFORD AVE
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453
Practice Address - Country:US
Practice Address - Phone:781-894-4325
Practice Address - Fax:781-894-1195
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health