Provider Demographics
NPI:1295860492
Name:MASHBURN, SHARI CATHLEAN
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:CATHLEAN
Last Name:MASHBURN
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 1:628 E COMMERCIAL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-3245
Mailing Address - Country:US
Mailing Address - Phone:417-869-6550
Mailing Address - Fax:417-869-9437
Practice Address - Street 1:628 E COMMERCIAL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-3245
Practice Address - Country:US
Practice Address - Phone:417-869-6550
Practice Address - Fax:417-869-9437
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235500000X
MO2004034768237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist