Provider Demographics
NPI:1740803527
Name:ROCHE, SHEILA CATHLEEN (SLP-CFY)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:CATHLEEN
Last Name:ROCHE
Suffix:
Gender:F
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-5505
Mailing Address - Country:US
Mailing Address - Phone:406-897-6070
Mailing Address - Fax:
Practice Address - Street 1:185 CRESTLINE AVE
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3573
Practice Address - Country:US
Practice Address - Phone:406-752-9612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-LTD-LIC-80235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist