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Individual

JAN F SHERBAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
3023 BROAD ST, CHATTANOOGA, TN 37408-3075
(423) 752-5207
(423) 752-5299
Mailing address
3023 BROAD ST, CHATTANOOGA, TN 37408-3075
(423) 752-5207
(423) 752-5299

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P02400
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3164854
BLUE CROSS BLUE SHIELD
TN
01
455336000
MAGELLAN
TN
Enumeration date
01/18/2007
Last updated
04/05/2011
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