Provider Demographics
NPI:1336624899
Name:ALDRICH, SHERRY STAPLETON (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:STAPLETON
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 HEALTH CARE DR
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24277-2854
Mailing Address - Country:US
Mailing Address - Phone:276-546-4566
Mailing Address - Fax:
Practice Address - Street 1:208 HEALTH CARE DR
Practice Address - Street 2:
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277-2854
Practice Address - Country:US
Practice Address - Phone:276-546-4566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002397235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist