Provider Demographics
NPI:1891485405
Name:ELMER, SHARLENE S (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:SHARLENE
Middle Name:S
Last Name:ELMER
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 W COUNTRY BEND DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-9485
Mailing Address - Country:US
Mailing Address - Phone:801-712-3066
Mailing Address - Fax:
Practice Address - Street 1:2255 W COUNTRY BEND DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-9485
Practice Address - Country:US
Practice Address - Phone:801-712-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT113802-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist