Provider Demographics
NPI:1548413818
Name:DONNELLY, CHERYLE LEIGH (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYLE
Middle Name:LEIGH
Last Name:DONNELLY
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 1:260 SCHODACK DR
Mailing Address - Street 2:
Mailing Address - City:CASTLETON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-3020
Mailing Address - Country:US
Mailing Address - Phone:518-732-4785
Mailing Address - Fax:
Practice Address - Street 1:260 SCHODACK DR
Practice Address - Street 2:
Practice Address - City:CASTLETON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12033-3020
Practice Address - Country:US
Practice Address - Phone:518-732-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9358-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist