MEDICARE: MS. SHERDRELL WASHINGTON

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	4276	SC

General Provider Information

NPI Number	:	1912202466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHERDRELL WASHINGTON

Provider Business Mailing Address
First Line	:	528 BATTERY PARK RD
Second Line	:
City	:	NESMITH
State	:	SC
Zip	:	29580-3046
Country	:	US
Telephone Number	:	803-873-4981
Fax Number	:

Provider Business Practice Location Address
First Line	:	528 BATTERY PARK RD
Second Line	:
City	:	NESMITH
State	:	SC
Zip	:	29580-3046
Country	:	US
Telephone Number	:	803-873-4981
Fax Number	:

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

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	01/13/2011

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Directions to “ MS. SHERDRELL WASHINGTON ” Practice Location

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