Provider Demographics
NPI:1457889917
Name:HEFFLEY, SHARON S
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:HEFFLEY
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 1:499 JOHN FOXS RUN
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-7539
Mailing Address - Country:US
Mailing Address - Phone:803-341-5214
Mailing Address - Fax:
Practice Address - Street 1:350 AUSTIN GRAYBILL RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-9251
Practice Address - Country:US
Practice Address - Phone:803-341-5214
Practice Address - Fax:803-341-5214
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6217235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist