Provider Demographics
NPI:1376710954
Name:WALKER SIDLES, SHERRY ELISE (MA, CCC, SLP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:ELISE
Last Name:WALKER SIDLES
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 1:23042 260TH AVE
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-9041
Mailing Address - Country:US
Mailing Address - Phone:641-437-1929
Mailing Address - Fax:
Practice Address - Street 1:23042 260TH AVE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-9041
Practice Address - Country:US
Practice Address - Phone:641-895-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist