Provider Demographics
NPI:1558111799
Name:SADBERRY, SHAMIR SHANTEL (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:SHAMIR
Middle Name:SHANTEL
Last Name:SADBERRY
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 BAUERLE RD APT 327
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6167
Mailing Address - Country:US
Mailing Address - Phone:318-450-5465
Mailing Address - Fax:
Practice Address - Street 1:3617 GENERAL PERSHING ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4530
Practice Address - Country:US
Practice Address - Phone:504-373-6274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9375235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist