Provider Demographics
NPI:1295248011
Name:GIVENS, SHERRI J (CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:J
Last Name:GIVENS
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 1:200 S WALNUT
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61883-1680
Mailing Address - Country:US
Mailing Address - Phone:1217-267-2154
Mailing Address - Fax:217-267-3484
Practice Address - Street 1:200 S WALNUT
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:IL
Practice Address - Zip Code:61883-1680
Practice Address - Country:US
Practice Address - Phone:217-267-2154
Practice Address - Fax:217-267-3484
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.004852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist