Provider Demographics
NPI:1598827719
Name:MAXWELL, SHERRI A (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:A
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:SHERRI
Other - Middle Name:A
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:PO BOX 221
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:MT
Mailing Address - Zip Code:59041-0221
Mailing Address - Country:US
Mailing Address - Phone:406-962-3943
Mailing Address - Fax:
Practice Address - Street 1:50 27TH ST W
Practice Address - Street 2:SUITE B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-8601
Practice Address - Country:US
Practice Address - Phone:406-651-9099
Practice Address - Fax:406-651-4332
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT729235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000661320OtherBCBS
MT533341Medicaid
MT81-0499449OtherPHYSICAL THERAPY IN MOTIO