Provider Demographics
NPI:1962833053
Name:LORIS, SHERRY (SLP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:LORIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3560 PRICE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6291
Mailing Address - Country:US
Mailing Address - Phone:406-281-0388
Mailing Address - Fax:
Practice Address - Street 1:3560 PRICE HILLS DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6291
Practice Address - Country:US
Practice Address - Phone:406-281-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-SP-TMP-2879235Z00000X
UT10798605-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist