Provider Demographics
NPI:1376795575
Name:KERRIDAN, SHERRY L
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:KERRIDAN
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 1:3326 E MAPLEWOOD ST.
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-9348
Mailing Address - Country:US
Mailing Address - Phone:480-516-1860
Mailing Address - Fax:
Practice Address - Street 1:3326 E MAPLEWOOD ST.
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-9348
Practice Address - Country:US
Practice Address - Phone:480-516-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL59772355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant