Provider Demographics
NPI:1215060348
Name:PRICE, SHERI L (CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:L
Last Name:PRICE
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEADWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63653-1214
Mailing Address - Country:US
Mailing Address - Phone:573-562-7558
Mailing Address - Fax:573-562-7512
Practice Address - Street 1:1124 MAIN ST
Practice Address - Street 2:WEST ST FRANCOIS CO R-IV
Practice Address - City:LEADWOOD
Practice Address - State:MO
Practice Address - Zip Code:63653-1214
Practice Address - Country:US
Practice Address - Phone:573-562-7558
Practice Address - Fax:573-562-7512
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116974235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO466031705Medicare ID - Type UnspecifiedMEDICAID #