Provider Demographics
NPI:1700387339
Name:ROBERTS, SHERYL A (SLPA)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:A
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 GILMAN PLZ
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3561
Mailing Address - Country:US
Mailing Address - Phone:207-990-0162
Mailing Address - Fax:207-990-0163
Practice Address - Street 1:28 GILMAN PLZ
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3561
Practice Address - Country:US
Practice Address - Phone:207-990-0162
Practice Address - Fax:207-990-0163
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant