Provider Demographics
NPI:1356754261
Name:HEADEXPRESSIONS BY SHERRY
Entity type:Organization
Organization Name:HEADEXPRESSIONS BY SHERRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STYLIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GATLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-206-1412
Mailing Address - Street 1:394 MILL ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1405
Mailing Address - Country:US
Mailing Address - Phone:203-206-1412
Mailing Address - Fax:
Practice Address - Street 1:394 MILL ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1405
Practice Address - Country:US
Practice Address - Phone:203-206-1412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies