Provider Demographics
NPI:1932924206
Name:SHERIDAN, NATALIE P (SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:P
Last Name:SHERIDAN
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 1:94 THRESHER RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-9117
Mailing Address - Country:US
Mailing Address - Phone:413-426-1983
Mailing Address - Fax:
Practice Address - Street 1:2030 BOSTON RD
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-3100
Practice Address - Country:US
Practice Address - Phone:413-426-1983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist