| Sherry Broadwell Phd Llc | |
|
517b Green Street Gainesville GA 30501 | |
| (706) 949-3131 | |
| Not Available |
| Full Name | Sherry Broadwell Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 517b Green Street, Gainesville, Georgia |
| Authorized Official Name and Position | Lynette Clark (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7703397667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sherry Broadwell Phd Llc Po Box 716 Clarkesville GA 30523-0012 Ph: (706) 949-3131 | Sherry Broadwell Phd Llc 517b Green Street Gainesville GA 30501 Ph: (706) 949-3131 |
| NPI Number | 1619583036 |
|---|---|
| Provider Enumeration Date | 09/21/2020 |
| Last Update Date | 09/21/2020 |
| Certification Date | 09/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619583036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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