Provider Demographics
NPI:1215280300
Name:JARRELL, SHERRI
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:JARRELL
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 1:4240 HUTCHINSON RIVER PKWY E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4746
Mailing Address - Country:US
Mailing Address - Phone:646-284-1117
Mailing Address - Fax:
Practice Address - Street 1:4240 HUTCHINSON RIVER PKWY E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4746
Practice Address - Country:US
Practice Address - Phone:646-284-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist