Provider Demographics
NPI:1093903536
Name:JONES, SHERYL KIM (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:KIM
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7035 IMPERIAL PL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:MT
Mailing Address - Zip Code:59741-8459
Mailing Address - Country:US
Mailing Address - Phone:406-282-7115
Mailing Address - Fax:
Practice Address - Street 1:7035 IMPERIAL PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:MT
Practice Address - Zip Code:59741-8459
Practice Address - Country:US
Practice Address - Phone:406-282-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist