Provider Demographics
NPI:1912202466
Name:WASHINGTON, SHERDRELL
Entity Type:Individual
Prefix:MS
First Name:SHERDRELL
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 BATTERY PARK RD
Mailing Address - Street 2:
Mailing Address - City:NESMITH
Mailing Address - State:SC
Mailing Address - Zip Code:29580-3046
Mailing Address - Country:US
Mailing Address - Phone:803-873-4981
Mailing Address - Fax:
Practice Address - Street 1:528 BATTERY PARK RD
Practice Address - Street 2:
Practice Address - City:NESMITH
Practice Address - State:SC
Practice Address - Zip Code:29580-3046
Practice Address - Country:US
Practice Address - Phone:803-873-4981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4276235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist