Provider Demographics
NPI:1609365899
Name:LYNCH, SHARON KISER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KISER
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-4107
Mailing Address - Country:US
Mailing Address - Phone:276-739-3906
Mailing Address - Fax:
Practice Address - Street 1:14050 GLENBROOK AVE
Practice Address - Street 2:
Practice Address - City:MEADOWVIEW
Practice Address - State:VA
Practice Address - Zip Code:24361-3348
Practice Address - Country:US
Practice Address - Phone:276-739-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002482235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist