Provider Demographics
NPI:1275887846
Name:WHITE, SHERI L
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 BLUE PRINCE RD
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-9577
Mailing Address - Country:US
Mailing Address - Phone:304-324-8358
Mailing Address - Fax:304-324-8308
Practice Address - Street 1:465 BLUE PRINCE RD
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-9577
Practice Address - Country:US
Practice Address - Phone:304-324-8358
Practice Address - Fax:304-324-8308
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV882237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist