Healthcare Provider Details

I. General information

NPI: 1477676302
Provider Name (Legal Business Name): SHERRY MAUREEN BUZARD M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2007
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14911 ROUTE 28 APT A
CORSICA PA
15829-2435
US

IV. Provider business mailing address

14911 ROUTE 28 APT A
CORSICA PA
15829-2435
US

V. Phone/Fax

Practice location:
  • Phone: 814-856-2552
  • Fax: 815-856-2552
Mailing address:
  • Phone: 814-856-2552
  • Fax: 815-856-2552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202006119
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12912
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number028253
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA16221
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL007133
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: