Provider Demographics
NPI:1215296306
Name:SHERIDAN, EMMA CLARE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:CLARE
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:CLARE
Other - Last Name:FEINAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:3699 ALEXANDRIA PIKE
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1789
Mailing Address - Country:US
Mailing Address - Phone:859-572-0430
Mailing Address - Fax:859-572-0163
Practice Address - Street 1:3699 ALEXANDRIA PIKE
Practice Address - Street 2:SUITE D
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-1789
Practice Address - Country:US
Practice Address - Phone:859-572-0430
Practice Address - Fax:859-572-0163
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY12-019235Z00000X
KY4235235Z00000X
KY138598235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist