Provider Demographics
NPI:1609953801
Name:NORVAL, SHARI K (AUD)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:K
Last Name:NORVAL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E WOODHURST DR STE Q100
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4240
Mailing Address - Country:US
Mailing Address - Phone:417-920-5434
Mailing Address - Fax:
Practice Address - Street 1:1200 E WOODHURST DR STE Q100
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4240
Practice Address - Country:US
Practice Address - Phone:417-920-5434
Practice Address - Fax:417-886-2072
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOHD 01327231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1609953801Medicaid
MO332325224Medicaid
MO219813268Medicare PIN
MO332325208Medicaid