Provider Demographics
NPI:1841496668
Name:SHERWOOD, PAULA ANN (SLP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ANN
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 BLACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:CRANE
Mailing Address - State:MO
Mailing Address - Zip Code:65633-9249
Mailing Address - Country:US
Mailing Address - Phone:417-723-8272
Mailing Address - Fax:417-723-8271
Practice Address - Street 1:1172 BLACKBERRY LN
Practice Address - Street 2:
Practice Address - City:CRANE
Practice Address - State:MO
Practice Address - Zip Code:65633-9249
Practice Address - Country:US
Practice Address - Phone:417-723-8272
Practice Address - Fax:417-723-8271
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105142235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist