Provider Demographics
NPI:1336798032
Name:BEECH, SHERRY A
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:A
Last Name:BEECH
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 1:1706 HIGHLAND CT
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-1317
Mailing Address - Country:US
Mailing Address - Phone:765-730-1552
Mailing Address - Fax:
Practice Address - Street 1:1706 HIGHLAND CT
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-1317
Practice Address - Country:US
Practice Address - Phone:765-730-1552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty