Provider Demographics
NPI:1346736253
Name:SHERBETJIAN, ROSEMARIE SONIA
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:SONIA
Last Name:SHERBETJIAN
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 1:3200 BROADWAY BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1571
Mailing Address - Country:US
Mailing Address - Phone:972-454-9309
Mailing Address - Fax:
Practice Address - Street 1:3200 BROADWAY BLVD STE 160
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1571
Practice Address - Country:US
Practice Address - Phone:972-454-9309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist