Provider Demographics
NPI:1649947755
Name:CHURICO, SHEILA MARIE
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:CHURICO
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 1:1900 CENTRE POINTE BLVD APT 113
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4878
Mailing Address - Country:US
Mailing Address - Phone:484-336-6497
Mailing Address - Fax:
Practice Address - Street 1:1900 CENTRE POINTE BLVD APT 113
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4878
Practice Address - Country:US
Practice Address - Phone:484-336-6497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor