Provider Demographics
NPI:1750058657
Name:WALTERS, SHARON (MA CCC-SLP, PHD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MA CCC-SLP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TAMASSEE SALEM ELEMENTARY
Mailing Address - Street 2:9950 NORTH HIGHWAY 11
Mailing Address - City:TAMASSEE
Mailing Address - State:SC
Mailing Address - Zip Code:29686
Mailing Address - Country:US
Mailing Address - Phone:864-886-4540
Mailing Address - Fax:
Practice Address - Street 1:TAMASSEE-SALEM ELEMENTARY
Practice Address - Street 2:9950 NORTH HIGHWAY 11
Practice Address - City:TAMASSEE
Practice Address - State:SC
Practice Address - Zip Code:29686
Practice Address - Country:US
Practice Address - Phone:864-886-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6981235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist