Provider Demographics
NPI:1346464310
Name:DUNN, CHERYL ANNE (MS CCCSLP)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANNE
Last Name:DUNN
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ANNE
Other - Last Name:PALM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 WEST PENNSYLVANIA
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711
Mailing Address - Country:US
Mailing Address - Phone:406-560-2916
Mailing Address - Fax:
Practice Address - Street 1:1771 OBSIDIAN LANE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711
Practice Address - Country:US
Practice Address - Phone:406-560-2916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT936235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0530910Medicaid
MT0530910Medicaid