Individual
SHERRY CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
306 MAIN ST, LOGAN, WV 25601-3906
(304) 752-7707
(304) 752-0772
Mailing address
306 MAIN ST, LOGAN, WV 25601-3906
(304) 752-7707
(304) 752-0772
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
493
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165516000
—
WV
Enumeration date
01/11/2007
Last updated
07/09/2007
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