Provider Demographics
NPI:1962017939
Name:DURDEN, SHARLA MECHELE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHARLA
Middle Name:MECHELE
Last Name:DURDEN
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 1:730 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32435-2587
Mailing Address - Country:US
Mailing Address - Phone:850-333-0317
Mailing Address - Fax:
Practice Address - Street 1:730 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32435-2587
Practice Address - Country:US
Practice Address - Phone:850-333-0317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8768235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist