Provider Demographics
NPI:1518121763
Name:HARWELL, SHARON (MED CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:HARWELL
Suffix:
Gender:F
Credentials:MED CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5879 BRENTWOOD TRCE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4659
Mailing Address - Country:US
Mailing Address - Phone:615-377-8105
Mailing Address - Fax:
Practice Address - Street 1:5879 BRENTWOOD TRCE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4659
Practice Address - Country:US
Practice Address - Phone:615-377-8105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1513235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1513OtherSTATE OF TENNESSEE, DEPARTMENT OF HEALTH LICENSURE AND REGULATION