Provider Demographics
NPI:1013702653
Name:WYRICK-HOLT, SHERIDA MATALIE
Entity type:Individual
Prefix:
First Name:SHERIDA
Middle Name:MATALIE
Last Name:WYRICK-HOLT
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:PO BOX 10864
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24543-5015
Mailing Address - Country:US
Mailing Address - Phone:434-799-7732
Mailing Address - Fax:434-733-7733
Practice Address - Street 1:159 EXECUTIVE DR STE A
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4160
Practice Address - Country:US
Practice Address - Phone:434-799-7732
Practice Address - Fax:434-799-7733
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant