Provider Demographics
NPI:1689942641
Name:BALLARD, SHARON (MS)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:BALLARD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FOGGINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-2715
Mailing Address - Country:US
Mailing Address - Phone:845-279-5051
Mailing Address - Fax:
Practice Address - Street 1:50 FOGGINTOWN RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-2715
Practice Address - Country:US
Practice Address - Phone:845-279-5051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist