Provider Demographics
NPI:1558724690
Name:KRAMER, CHERYL STONER (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:STONER
Last Name:KRAMER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 VIA HAVARRE
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-2924
Mailing Address - Country:US
Mailing Address - Phone:321-987-8615
Mailing Address - Fax:321-459-2465
Practice Address - Street 1:105 N GROVE ST
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3441
Practice Address - Country:US
Practice Address - Phone:321-459-1313
Practice Address - Fax:321-459-9494
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01088902OtherASHA NUMBER
FLL15000134762OtherLIMITED LIABILITY COMPANY NUMBER
FLSA3200OtherFL STATE LICENSE