MEDICARE: SHERRY SANDERS REEVES PSY.D., LLC

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	PY0004981	FL

General Provider Information

NPI Number	:	1467635458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY SANDERS REEVES PSY.D., LLC

Provider Business Mailing Address
First Line	:	870 CLARK ST
Second Line	:	SUITE 1020
City	:	OVIEDO
State	:	FL
Zip	:	32765-9270
Country	:	US
Telephone Number	:	407-701-1135
Fax Number	:

Provider Business Practice Location Address
First Line	:	870 CLARK ST
Second Line	:	SUITE 1020
City	:	OVIEDO
State	:	FL
Zip	:	32765-9270
Country	:	US
Telephone Number	:	407-701-1135
Fax Number	:

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

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	01/30/2014

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