Provider Demographics
NPI:1417570813
Name:SCHALL, CHERYL ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:SCHALL
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 1:401 SUNSET ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1010
Mailing Address - Country:US
Mailing Address - Phone:734-306-4707
Mailing Address - Fax:
Practice Address - Street 1:401 SUNSET ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1010
Practice Address - Country:US
Practice Address - Phone:734-306-4707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101003909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist