Provider Demographics
NPI:1346396595
Name:PAYNE, SHERAMI JO (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERAMI
Middle Name:JO
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 WICHITA RD
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-8235
Mailing Address - Country:US
Mailing Address - Phone:720-233-3352
Mailing Address - Fax:
Practice Address - Street 1:287 WICHITA RD
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540-8235
Practice Address - Country:US
Practice Address - Phone:720-233-3352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist