Provider Demographics
NPI:1891807830
Name:TEMPLE, SHEILA MARY (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:MARY
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BOUCHARD AVE NE
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-2407
Mailing Address - Country:US
Mailing Address - Phone:828-874-8847
Mailing Address - Fax:828-874-8847
Practice Address - Street 1:501 BOUCHARD AVE NE
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2407
Practice Address - Country:US
Practice Address - Phone:828-874-8847
Practice Address - Fax:828-874-8847
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC138XTOtherBLUE CROSS BLUE SHIELD
NC7411745Medicaid