Provider Demographics
NPI:1205951852
Name:ZEMLICK, SHERRY LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:LYNN
Last Name:ZEMLICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 EAST 900 SOUTH
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-1452
Mailing Address - Country:US
Mailing Address - Phone:801-596-0147
Mailing Address - Fax:801-596-9902
Practice Address - Street 1:989 E 900 S
Practice Address - Street 2:SUITE A-2
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-1473
Practice Address - Country:US
Practice Address - Phone:801-596-0147
Practice Address - Fax:801-596-9902
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT110670-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107007005101OtherSELECT HEALTH (IHC)
UT5282529OtherAETNA INSURANCE
UT59601OtherUNI BEHAVIORAL HEALTH
UT13124OtherPEHP