Provider Demographics
NPI:1932640505
Name:MEJIA, SHERLIE (SPL)
Entity Type:Individual
Prefix:MRS
First Name:SHERLIE
Middle Name:
Last Name:MEJIA
Suffix:
Gender:F
Credentials:SPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1B CALLE GLADIOLA
Mailing Address - Street 2:CIUDAD JARDIN DE CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-378-3200
Mailing Address - Fax:
Practice Address - Street 1:B1 CALLE GLADIOLA
Practice Address - Street 2:CIUDAD JARDIN B1
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-2200
Practice Address - Country:US
Practice Address - Phone:787-378-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1019235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist