Provider Demographics
NPI:1306024336
Name:SHERRILL, ROSALIND D (EDD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:ROSALIND
Middle Name:D
Last Name:SHERRILL
Suffix:
Gender:F
Credentials:EDD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WISTERIA BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-7205
Mailing Address - Country:US
Mailing Address - Phone:770-861-0975
Mailing Address - Fax:
Practice Address - Street 1:240 WISTERIA BLVD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-7205
Practice Address - Country:US
Practice Address - Phone:770-861-0975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003507235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist