Provider Demographics
NPI:1033314091
Name:RICHARDSON, SHEREE S (AUDIOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:SHEREE
Middle Name:S
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:900 RIDGE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1726
Mailing Address - Country:US
Mailing Address - Phone:219-836-8408
Mailing Address - Fax:219-836-9656
Practice Address - Street 1:900 RIDGE RD
Practice Address - Street 2:SUITE E
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1726
Practice Address - Country:US
Practice Address - Phone:219-836-8408
Practice Address - Fax:219-836-9656
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001547A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist