Provider Demographics
NPI:1073972873
Name:BIRMINGHAM, SHERI (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:BIRMINGHAM
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 PROFESSIONAL PLZ # 101
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-7915
Mailing Address - Country:US
Mailing Address - Phone:901-328-2110
Mailing Address - Fax:
Practice Address - Street 1:3180 PROFESSIONAL PLZ # 101
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-7915
Practice Address - Country:US
Practice Address - Phone:901-328-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5828235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist