Provider Demographics
NPI:1174825392
Name:BEAULIEU, CHERYL ANNE (MS-CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:BEAULIEU
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 1:21 JAMIES LN
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05048-9654
Mailing Address - Country:US
Mailing Address - Phone:802-436-1732
Mailing Address - Fax:
Practice Address - Street 1:289 COUNTY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VT
Practice Address - Zip Code:05089-9000
Practice Address - Country:US
Practice Address - Phone:802-674-7297
Practice Address - Fax:802-674-7150
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist