Provider Demographics
NPI:1942466644
Name:SHERWOOD, KRISTY J (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:J
Last Name:SHERWOOD
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 1:203 COCKLEYS DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5810
Mailing Address - Country:US
Mailing Address - Phone:717-578-8438
Mailing Address - Fax:
Practice Address - Street 1:5225 WILSON LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6663
Practice Address - Country:US
Practice Address - Phone:717-591-8063
Practice Address - Fax:717-697-6576
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007002235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist