Healthcare Provider Details

I. General information

NPI: 1376382440
Provider Name (Legal Business Name): SHERRY ARNOWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 PASEO DEL CANON W
TAOS NM
87571-6743
US

IV. Provider business mailing address

1480 AVENIDA RINCON UNIT 103
SANTA FE NM
87506-6013
US

V. Phone/Fax

Practice location:
  • Phone: 908-343-6457
  • Fax:
Mailing address:
  • Phone: 908-343-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number383247
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: