Provider Demographics
NPI:1871749317
Name:NORTH, SHERRI DESHAY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:DESHAY
Last Name:NORTH
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 1:223 14TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-1212
Mailing Address - Country:US
Mailing Address - Phone:505-573-4830
Mailing Address - Fax:505-213-2819
Practice Address - Street 1:223 14TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1212
Practice Address - Country:US
Practice Address - Phone:505-573-4830
Practice Address - Fax:505-213-2819
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1190235Z00000X
NM4717235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist