Provider Demographics
NPI:1376859652
Name:WALKLEY, CHERIE MICHELLE (MS, CCC-SLP, IBCLC)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:MICHELLE
Last Name:WALKLEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14015 INDEPENDENCE RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7213
Mailing Address - Country:US
Mailing Address - Phone:817-880-3433
Mailing Address - Fax:
Practice Address - Street 1:14015 INDEPENDENCE RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7213
Practice Address - Country:US
Practice Address - Phone:817-880-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X, 235Z00000X
AZTSLP6882235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN