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General NPI Number Information
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NPI Number | 1356776728
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Entity Type | Individual
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Provider Name | SHERRY RENEE WARD B.S.
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Gender | Female
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 2505 N BROADWAY ST
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City | POTEAU
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State | OK
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Zip | 74953-2050
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Country | US
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Telephone | 918-635-5082
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | TALIHINA
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State | OK
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Zip | 74571-0218
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Country | US
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Telephone | 918-429-9249
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PARAPROFESSIONAL
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License Number State | OK
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