Provider Demographics
NPI:1821212234
Name:BROGDEN, SHARON W (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:W
Last Name:BROGDEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:W
Other - Last Name:HACKLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:2622 GRIST MILL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-3821
Mailing Address - Country:US
Mailing Address - Phone:501-247-5090
Mailing Address - Fax:
Practice Address - Street 1:SALINE MEMORIAL HOSPITAL
Practice Address - Street 2:1 MEDICAL PARK DRIVE
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015
Practice Address - Country:US
Practice Address - Phone:501-776-6925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist