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General NPI Number Information
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NPI Number | 1245513175
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Entity Type | Individual
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Provider Name | SHERRI KONING
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Gender | Female
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 333 1ST ST N SUITE 200
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-6945
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Country | US
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Telephone | 866-301-5038
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Fax | 888-711-5039
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Provider Business Mailing Address
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Address Line | 4370 SCHINDLER RD
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City | FALLON
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State | NV
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Zip | 89406-7297
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0881
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-722
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License Number State | ID
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