Provider Demographics
NPI:1942854161
Name:SHERRELL, KIRSTIN
Entity Type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:
Last Name:SHERRELL
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 1:603 TRAIL SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-4491
Mailing Address - Country:US
Mailing Address - Phone:713-302-4349
Mailing Address - Fax:
Practice Address - Street 1:23775 KINGWOOD PLACE DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3817
Practice Address - Country:US
Practice Address - Phone:281-318-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant