Provider Demographics
NPI:1942453204
Name:ADAMS, SHERI K (MA, CCC)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:K
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1574 TURNER RD
Mailing Address - Street 2:
Mailing Address - City:GRACE
Mailing Address - State:ID
Mailing Address - Zip Code:83241-5049
Mailing Address - Country:US
Mailing Address - Phone:208-851-2808
Mailing Address - Fax:
Practice Address - Street 1:1574 TURNER RD
Practice Address - Street 2:
Practice Address - City:GRACE
Practice Address - State:ID
Practice Address - Zip Code:83241-5049
Practice Address - Country:US
Practice Address - Phone:208-851-2808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR246716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist