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General NPI Number Information
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NPI Number | 1013504083
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Entity Type | Individual
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Provider Name | SHERRY LYNN RAABE PHDHP
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Gender | Female
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Dates
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Enumeration Date | 12/24/2020
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 106 CHERRY RIDGE LN
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City | WEST SUNBURY
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State | PA
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Zip | 16061-2234
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Country | US
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Telephone | 814-229-9352
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Fax |
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Provider Business Mailing Address
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Address Line | 106 CHERRY RIDGE LN
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City | WEST SUNBURY
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State | PA
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Zip | 16061-2234
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Country | US
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Telephone | 814-229-9352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH069520
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | PHDH000248
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License Number State | PA
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