Healthcare Provider Details

I. General information

NPI: 1538269550
Provider Name (Legal Business Name): SHERRI SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 11/07/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 OHIO RIVER ROAD
HUNTINGTON WV
25702
US

IV. Provider business mailing address

4810 OHIO RIVER ROAD
HUNTINGTON WV
25702
US

V. Phone/Fax

Practice location:
  • Phone: 304-412-0358
  • Fax: 304-736-5438
Mailing address:
  • Phone: 304-412-0358
  • Fax: 304-736-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP 4089
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP-0187
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: