Basic Information
| Provider Information | |||||||||
| NPI: | 1902192073 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCAULIFFE | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | SLP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HARRINGTON | ||||||||
| OtherFirstName: | SHERRY | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | SLP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 555 RANCH ROAD 3237 | ||||||||
| Address2: | |||||||||
| City: | WIMBERLEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786765311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128475540 | ||||||||
| FaxNumber: | 5128470419 | ||||||||
| Practice Location | |||||||||
| Address1: | 555 RANCH ROAD 3237 | ||||||||
| Address2: | |||||||||
| City: | WIMBERLEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786765311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5128475540 | ||||||||
| FaxNumber: | 5128470419 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2011 | ||||||||
| LastUpdateDate: | 06/27/2011 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 16594 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.