Provider Demographics
NPI:1699923896
Name:EDWARDS, SHERYL ANN (SLP)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W SENECA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-3342
Mailing Address - Country:US
Mailing Address - Phone:607-277-8020
Mailing Address - Fax:
Practice Address - Street 1:1001 W SENECA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-3342
Practice Address - Country:US
Practice Address - Phone:607-277-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002533-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist