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NPI Code Detail

MEDICARE: PROF. SHERRI W SHUNFENTHAL SLP/CCC

MEDICARE:  PROF. SHERRI W SHUNFENTHAL  SLP/CCC
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
1235Z00000XSpeech-Language Pathologist2202001445VA

General Provider Information

NPI Number : 1750514311
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. SHERRI W SHUNFENTHAL SLP/CCC
Provider Business Mailing Address
First Line : 9501 ORION CT
Second Line :
City : BURKE
State : VA
Zip : 22015-3241
Country : US
Telephone Number : 703-866-9729
Fax Number :
Provider Business Practice Location Address
First Line : 9642 BURKE LAKE RD
Second Line :
City : BURKE
State : VA
Zip : 22015-3052
Country : US
Telephone Number : 703-425-1698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2009
Last Update Date : 08/31/2009

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Directions to “ PROF. SHERRI W SHUNFENTHAL SLP/CCC” Practice Location

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