MEDICARE: SHARON SMITH PALMER SLP

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	30153	CA
2	235Z00000X	Speech-Language Pathologist	6751021-4102	UT

General Provider Information

NPI Number	:	1962029454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON SMITH PALMER SLP

Provider Business Mailing Address
First Line	:	120 N 4125 W
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8099
Country	:	US
Telephone Number	:	435-559-1081
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 N 4125 W
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-8099
Country	:	US
Telephone Number	:	435-559-1081
Fax Number	:

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

Provider Enumeration Date	:	06/30/2020
Last Update Date	:	06/30/2020

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Directions to “ SHARON SMITH PALMER SLP” Practice Location

Language	Start Address	Practice Location

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