Provider Demographics
NPI:1154560167
Name:NEVILLE-MITCHELL, SHARON (MSCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:NEVILLE-MITCHELL
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8424 N NEVADA ST
Mailing Address - Street 2:#186
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-7316
Mailing Address - Country:US
Mailing Address - Phone:509-467-2590
Mailing Address - Fax:
Practice Address - Street 1:8424 N NEVADA ST
Practice Address - Street 2:#186
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-7316
Practice Address - Country:US
Practice Address - Phone:509-467-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist