=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477676302
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHERRY MAUREEN BUZARD M.S. CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2007
-----------------------------------------------------
Last Update Date | 10/23/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14911 ROUTE 28 APT A
-----------------------------------------------------
City | CORSICA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15829-2435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-856-2552
-----------------------------------------------------
Fax | 815-856-2552
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14911 ROUTE 28 APT A
-----------------------------------------------------
City | CORSICA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15829-2435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-856-2552
-----------------------------------------------------
Fax | 815-856-2552
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 2202006119
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 12912
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 028253
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SA16221
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SL007133
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------