Provider Demographics
NPI:1003967886
Name:ADDINGTON, SHERI KAY (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:KAY
Last Name:ADDINGTON
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 CATFISH DR
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74604-5834
Mailing Address - Country:US
Mailing Address - Phone:580-765-3537
Mailing Address - Fax:
Practice Address - Street 1:229 CATFISH DR
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74604-5834
Practice Address - Country:US
Practice Address - Phone:580-765-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3369235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM25452215Medicaid