Individual
SHERIKA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6921 NW 22ND ST, GAINESVILLE, FL 32653-1228
(352) 554-5231
Mailing address
5758 NW 63RD PL, OCALA, FL 34482-7657
(352) 301-0642
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
104017500
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104017500
—
FL
01
—
320900000X
HOME AND COMMUNITY BASED SERVICES WAIVER
FL
05
—
320900000X
—
FL
Enumeration date
02/14/2022
Last updated
02/14/2022
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