Provider Demographics
NPI:1376816967
Name:SHERIFF, LINDA SUSAN (SPEECH-LANGUAGE PATH)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUSAN
Last Name:SHERIFF
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:SUSAN
Other - Last Name:MATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPEECH-LANGUAGE PATH
Mailing Address - Street 1:P.O. BOX 1409
Mailing Address - Street 2:
Mailing Address - City:CAMDENTON
Mailing Address - State:MO
Mailing Address - Zip Code:65020
Mailing Address - Country:US
Mailing Address - Phone:573-346-9242
Mailing Address - Fax:573-346-9290
Practice Address - Street 1:158 MINOR STREET
Practice Address - Street 2:
Practice Address - City:CAMDENTON
Practice Address - State:MO
Practice Address - Zip Code:65020
Practice Address - Country:US
Practice Address - Phone:573-346-9239
Practice Address - Fax:573-346-9291
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010017713235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist