Provider Demographics
NPI:1093914848
Name:FOUST, SHERRY J (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:J
Last Name:FOUST
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:N17114 VISTA VIEW LN
Mailing Address - Street 2:
Mailing Address - City:TREMPEALEAU
Mailing Address - State:WI
Mailing Address - Zip Code:54661-7252
Mailing Address - Country:US
Mailing Address - Phone:507-474-3260
Mailing Address - Fax:
Practice Address - Street 1:ST. MICHAEL'S LUTHERAN HOME
Practice Address - Street 2:270 NORTH ST.
Practice Address - City:FOUNTAIN CITY
Practice Address - State:WI
Practice Address - Zip Code:54629
Practice Address - Country:US
Practice Address - Phone:608-858-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2888-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist