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General NPI Number Information
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NPI Number | 1023923760
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Entity Type | Individual
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Provider Name | SHERYL ANN GILLEN
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Gender | Female
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | PO BOX 271
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City | PECKVILLE
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State | PA
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Zip | 18452-0271
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Country | US
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Telephone | 570-383-4963
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Fax |
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Provider Business Mailing Address
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Address Line | 1813 MAIN ST REAR
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City | BLAKELY
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State | PA
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Zip | 18447-1265
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Country | US
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Telephone |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MSG000378
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License Number State | PA
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