Doctor Name: | MS. SHERRY G BLACKWOOD |
NPI Number: | 1295068781 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MCD, CCC-SLP |
License Number: | LA 2617 |
Business Practice Address: | 208 Sweetwater Rim Pineville, LA - 713605691 |
Business Phone Number: | 3184198176 |
Business Fax Number: | |
Mailing Address: | 4126 Maryland Ave, SHREVEPORT |
State: | LA |
Postal Code: | 711061438 |
Phone Number: | 3184707600 |
Fax Number: | 3188682468 |
NPI Enumeration Date: | 09/15/2009 |
NPI Last Update Date: | 09/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LA 2617 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |