Provider Demographics
NPI:1902243918
Name:MCMILLAN, SHERNE-MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERNE-MARIE
Middle Name:
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2842
Mailing Address - Country:US
Mailing Address - Phone:458-836-8216
Mailing Address - Fax:
Practice Address - Street 1:750 SHIPYARD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5157
Practice Address - Country:US
Practice Address - Phone:302-658-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001271235Z00000X
CA30315235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist