Provider Demographics
NPI:1215162821
Name:NEUKAM, SHARON (MA/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:NEUKAM
Suffix:
Gender:F
Credentials:MA/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 E WILLOW AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-4621
Practice Address - Country:US
Practice Address - Phone:513-984-8456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.8653235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist