Provider Demographics
NPI:1144045667
Name:PERRY, SHERRIA E (CCHW)
Entity type:Individual
Prefix:
First Name:SHERRIA
Middle Name:E
Last Name:PERRY
Suffix:
Gender:F
Credentials:CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30150 PALMER BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1826
Mailing Address - Country:US
Mailing Address - Phone:313-454-6051
Mailing Address - Fax:
Practice Address - Street 1:30150 PALMER BLVD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1826
Practice Address - Country:US
Practice Address - Phone:313-454-6051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker