Individual
TANYA DESIRAE SHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1301 DOTSY AVE, ODESSA, TX 79763-3576
(432) 456-0029
Mailing address
5001 W WADLEY AVE APT D311, MIDLAND, TX 79707-5143
(432) 230-9951
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT8162
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE, AND RESTORATIVE SERVICE PROVIDERS
TX
Enumeration date
02/21/2020
Last updated
03/03/2020
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