Provider Demographics
NPI:1235328535
Name:MARTIN, SHERRY ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:ANN
Last Name:MARTIN
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 1:1102 COUNTY ROAD 241
Mailing Address - Street 2:
Mailing Address - City:BECKVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75631-4629
Mailing Address - Country:US
Mailing Address - Phone:903-694-3148
Mailing Address - Fax:
Practice Address - Street 1:1102 COUNTY ROAD 241
Practice Address - Street 2:
Practice Address - City:BECKVILLE
Practice Address - State:TX
Practice Address - Zip Code:75631-4629
Practice Address - Country:US
Practice Address - Phone:903-694-3148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14028235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist