Provider Demographics
NPI:1730527946
Name:SOUTHERLIN, SHARON CASH (MED, MCD, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:CASH
Last Name:SOUTHERLIN
Suffix:
Gender:F
Credentials:MED, MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 EASLEY HIGHWAY
Mailing Address - Street 2:SPEARMAN ELEMENTARY
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673
Mailing Address - Country:US
Mailing Address - Phone:864-947-9787
Mailing Address - Fax:864-947-1162
Practice Address - Street 1:2001 EASLEY HWY
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-7520
Practice Address - Country:US
Practice Address - Phone:864-947-9787
Practice Address - Fax:864-947-1162
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1104973577Medicaid