Sharon Bennett
Individual provider Active NPI Speech-Language Pathologist · Nixa, MO
NPI 1083044101 · NPPES record last updated Nov 26, 2013
Key facts
- NPI
- 1083044101
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP#3408 (AR)
- Practice address
- 512 S Pepperhill Dr
Nixa, MO 65714-7180 - Phone
- (417) 569-2890
- NPI assigned
- Nov 26, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP#3408 | AR | MD | Speech-Language Pathologist |
| 114514 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#3408 | AR | Yes |
| Speech-Language Pathologist | 235Z00000X | 114514 | MO |
Addresses
Primary practice location
512 S Pepperhill Dr
Nixa, MO 65714-7180
Mailing address
512 S Pepperhill Dr
Nixa, MO 65714-7180
Other providers in Nixa, MO
- Michelle Lee Balek
- Barbara K. Hylton
- Robert Wayne Barnett
- Brendan D Beckley
- Julie Loree Baxter Bennett
- Elizabeth Betebenner
- John Paul Billingsley
- Leslie L Binder
- Julie Ann Blackford
- Charles Bartlett Blake
All providers in Nixa, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.