Provider Demographics
NPI:1538180682
Name:SWAIM, SHERRY LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNN
Last Name:SWAIM
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 S 104TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-5356
Mailing Address - Country:US
Mailing Address - Phone:479-484-1760
Mailing Address - Fax:479-484-1760
Practice Address - Street 1:3009 S 104TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5356
Practice Address - Country:US
Practice Address - Phone:479-484-1760
Practice Address - Fax:479-484-1760
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP718235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5S490OtherBLUE CROSS BLUE SHIELD