Provider Demographics
NPI:1740935329
Name:JENKINS, SHERRY LEANN
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:LEANN
Last Name:JENKINS
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 1:32819 GREEN BEND CT
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-6860
Mailing Address - Country:US
Mailing Address - Phone:903-767-0435
Mailing Address - Fax:
Practice Address - Street 1:2203 TIMBERLOCH PL STE 125
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1150
Practice Address - Country:US
Practice Address - Phone:713-303-9627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-13
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85188101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional