Provider Demographics
NPI:1821185570
Name:MCCOY, SHARISSE DEMISHIA (AUD)
Entity Type:Individual
Prefix:DR
First Name:SHARISSE
Middle Name:DEMISHIA
Last Name:MCCOY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 HIGHLAND RD E STE A5
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-2150
Mailing Address - Country:US
Mailing Address - Phone:330-468-0337
Mailing Address - Fax:
Practice Address - Street 1:8787 BROOKPARK ROAD
Practice Address - Street 2:LOUIS STOKES DEPARTMENT OF VETERANS AFFAIRS PARMA MED C
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129
Practice Address - Country:US
Practice Address - Phone:216-739-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01096231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist