Healthcare Provider Details

I. General information

NPI: 1275349029
Provider Name (Legal Business Name): HATTIE SHERRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 INDIAN WELLS RD
ALAMOGORDO NM
88310-4609
US

IV. Provider business mailing address

2360 INDIAN WELLS RD
ALAMOGORDO NM
88310-4609
US

V. Phone/Fax

Practice location:
  • Phone: 575-437-7404
  • Fax:
Mailing address:
  • Phone: 575-437-7404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: