Provider Demographics
NPI:1982174611
Name:SIMONE, SHERRY ANN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:SIMONE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5302 NORRISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-8995
Mailing Address - Country:US
Mailing Address - Phone:410-692-7810
Mailing Address - Fax:
Practice Address - Street 1:5302 NORRISVILLE RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:MD
Practice Address - Zip Code:21161-8995
Practice Address - Country:US
Practice Address - Phone:410-692-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist