Healthcare Provider Details

I. General information

NPI: 1487873592
Provider Name (Legal Business Name): SHERRI JO NEWELL-SORRELL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E CLEVELAND ST
MONETT MO
65708
US

IV. Provider business mailing address

700 E CLEVELAND ST
MONETT MO
65708
US

V. Phone/Fax

Practice location:
  • Phone: 417-236-2480
  • Fax: 417-236-2481
Mailing address:
  • Phone: 417-236-2480
  • Fax: 417-236-2481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number003559
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: