Provider Demographics
NPI:1285401307
Name:SHERRARD, DONNA JEAN
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:SHERRARD
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 1:6 PLANTATION DR APT 105
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-7918
Mailing Address - Country:US
Mailing Address - Phone:863-221-7223
Mailing Address - Fax:
Practice Address - Street 1:6 PLANTATION DR APT 105
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-7918
Practice Address - Country:US
Practice Address - Phone:863-221-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty