Provider Demographics
NPI:1164793527
Name:HALL, SHERYE MOORE (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:SHERYE
Middle Name:MOORE
Last Name:HALL
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:EAST BEND
Mailing Address - State:NC
Mailing Address - Zip Code:27018-8742
Mailing Address - Country:US
Mailing Address - Phone:336-749-1976
Mailing Address - Fax:
Practice Address - Street 1:1140 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:EAST BEND
Practice Address - State:NC
Practice Address - Zip Code:27018-8742
Practice Address - Country:US
Practice Address - Phone:336-749-1976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1927235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist