Provider Demographics
NPI:1457533770
Name:COCKMAN, SHELIA (BC-HIS)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:COCKMAN
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 S COMMERCIAL ST
Mailing Address - Street 2:STE A
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-1603
Mailing Address - Country:US
Mailing Address - Phone:816-925-4575
Mailing Address - Fax:816-925-4575
Practice Address - Street 1:803 S COMMERCIAL ST STE A
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-1632
Practice Address - Country:US
Practice Address - Phone:816-925-4575
Practice Address - Fax:816-925-4575
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007014669237700000X
KS1446237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist