Individual
MRS. ANEISA LYNN SHERRILL-MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2401 BERNADETTE DR STE 201, COLUMBIA, MO 65203-4672
(573) 289-2167
Mailing address
408 VINE ST, BOONVILLE, MO 65233-1578
(573) 289-2167
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011029060
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490078150
—
MO
Enumeration date
12/02/2014
Last updated
03/04/2025
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