Provider Demographics
NPI:1134319668
Name:SIMPSON, CHERYL A (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:A
Last Name:SIMPSON
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 1:207 THIRD AVE EAST
Mailing Address - Street 2:
Mailing Address - City:RAY
Mailing Address - State:ND
Mailing Address - Zip Code:58849
Mailing Address - Country:US
Mailing Address - Phone:701-568-3520
Mailing Address - Fax:
Practice Address - Street 1:207 THIRD AVE EAST
Practice Address - Street 2:
Practice Address - City:RAY
Practice Address - State:ND
Practice Address - Zip Code:58849-0334
Practice Address - Country:US
Practice Address - Phone:701-568-3520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND506235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND50294Medicaid
ND26729OtherBC/BS OF ND