MEDICARE: DR. HELEN MARIE SHERRY PH.D.

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	106H00000X	Marriage & Family Therapist	MFT15632	CA

General Provider Information

NPI Number	:	1568487775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELEN MARIE SHERRY PH.D.

Provider Business Mailing Address
First Line	:	708 E. GRAND AVE.
Second Line	:	SUITE D
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420
Country	:	US
Telephone Number	:	805-489-7131
Fax Number	:	805-489-7131

Provider Business Practice Location Address
First Line	:	708 E GRAND AVE
Second Line	:	SUITE D
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-3244
Country	:	US
Telephone Number	:	805-489-7131
Fax Number	:	805-489-7131

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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