Provider Demographics
NPI:1487793519
Name:HALL, SHARON C (SLP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:C
Last Name:HALL
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 1:1970 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2730
Mailing Address - Country:US
Mailing Address - Phone:423-426-2377
Mailing Address - Fax:423-926-9391
Practice Address - Street 1:1970 MICHAEL DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2730
Practice Address - Country:US
Practice Address - Phone:423-426-2377
Practice Address - Fax:423-926-9391
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN897235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist