MEDICARE: MS. SHERRY B HURWITZ LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	000111	GA

General Provider Information

NPI Number	:	1124200415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHERRY B HURWITZ LMFT

Provider Business Mailing Address
First Line	:	3120 N OAK STREET EXT
Second Line	:	SUITE C
City	:	VALDOSTA
State	:	GA
Zip	:	31602-5909
Country	:	US
Telephone Number	:	229-671-6140
Fax Number	:	229-671-6740

Provider Business Practice Location Address
First Line	:	3120 N OAK STREET EXT
Second Line	:	SUITE C
City	:	VALDOSTA
State	:	GA
Zip	:	31602-5909
Country	:	US
Telephone Number	:	229-671-6140
Fax Number	:	229-671-6740

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	11/29/2007

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