Provider Demographics
NPI:1255999769
Name:SORRELLS, SHECARI LEONE
Entity type:Individual
Prefix:
First Name:SHECARI
Middle Name:LEONE
Last Name:SORRELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 971582
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-0191
Mailing Address - Country:US
Mailing Address - Phone:734-657-2251
Mailing Address - Fax:734-483-5643
Practice Address - Street 1:14 S HURON ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-5488
Practice Address - Country:US
Practice Address - Phone:734-657-2251
Practice Address - Fax:734-483-5643
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator