MEDICARE: SHERI N. BONNER CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	1569	NC

General Provider Information

NPI Number	:	1023132651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERI N. BONNER CCC-SLP

Provider Business Mailing Address
First Line	:	912 N ELM ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1513
Country	:	US
Telephone Number	:	336-275-2400
Fax Number	:	336-275-2122

Provider Business Practice Location Address
First Line	:	912 N ELM ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1513
Country	:	US
Telephone Number	:	336-275-2400
Fax Number	:	336-275-2122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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Directions to “ SHERI N. BONNER CCC-SLP” Practice Location

Language	Start Address	Practice Location

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