MEDICARE: SHERI VANINO PSYD

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	103TC0700X	Clinical Psychologist	2912	CO

General Provider Information

NPI Number	:	1417374687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERI VANINO PSYD

Provider Business Mailing Address
First Line	:	1720 S BELLAIRE ST STE 907
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4333
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 S BELLAIRE ST STE 907
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4333
Country	:	US
Telephone Number	:	303-250-1340
Fax Number	:

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

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	03/25/2014

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