Provider Demographics
NPI:1003206186
Name:KNOX, SHEILA (MED,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:KNOX
Suffix:
Gender:F
Credentials:MED,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 GREENHILL BLVD NW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3066
Mailing Address - Country:US
Mailing Address - Phone:256-979-1222
Mailing Address - Fax:256-979-1223
Practice Address - Street 1:2804 GREENHILL BLVD NW
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3066
Practice Address - Country:US
Practice Address - Phone:256-979-1222
Practice Address - Fax:256-979-1223
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist