Provider Demographics
NPI:1629076484
Name:DUCOMBS, SHERRY C (MCD, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:C
Last Name:DUCOMBS
Suffix:
Gender:F
Credentials:MCD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15706 PROFESSIONAL PLZ
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1451
Mailing Address - Country:US
Mailing Address - Phone:985-542-2521
Mailing Address - Fax:985-542-0474
Practice Address - Street 1:15706 PROFESSIONAL PLZ
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1451
Practice Address - Country:US
Practice Address - Phone:985-542-2521
Practice Address - Fax:985-542-0474
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2519231H00000X, 231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA111714Medicaid
LA1125563Medicaid
P51630Medicare UPIN
LA111714Medicaid