Provider Demographics
NPI:1568893691
Name:THIGPEN, SHERON S (SLP)
Entity Type:Individual
Prefix:
First Name:SHERON
Middle Name:S
Last Name:THIGPEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 537
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-0537
Mailing Address - Country:US
Mailing Address - Phone:706-592-5565
Mailing Address - Fax:706-751-0825
Practice Address - Street 1:2485 HIGHWAY 88
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-4691
Practice Address - Country:US
Practice Address - Phone:706-592-5565
Practice Address - Fax:706-751-0825
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist