Provider Demographics
NPI:1831193754
Name:STUMP, SHERRIE HELEN (MA, F-AAA)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:HELEN
Last Name:STUMP
Suffix:
Gender:F
Credentials:MA, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6416
Mailing Address - Country:US
Mailing Address - Phone:740-383-8060
Mailing Address - Fax:740-383-7974
Practice Address - Street 1:1040 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6416
Practice Address - Country:US
Practice Address - Phone:740-383-8060
Practice Address - Fax:740-383-7974
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-01316231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0100147Medicaid
OH4012811Medicare PIN
OHP00897Medicare UPIN
OH0100147Medicaid