Provider Demographics
NPI:1043531031
Name:HARDING, CHERYL A (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:A
Last Name:HARDING
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 1:559 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1824
Mailing Address - Country:US
Mailing Address - Phone:708-386-0720
Mailing Address - Fax:
Practice Address - Street 1:559 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1824
Practice Address - Country:US
Practice Address - Phone:708-828-7488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.004046235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist