Provider Demographics
NPI:1578713111
Name:DANIEL, CHERYL
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8780 S US HIGHWAY 421
Mailing Address - Street 2:
Mailing Address - City:CAWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40815-5218
Mailing Address - Country:US
Mailing Address - Phone:606-573-1069
Mailing Address - Fax:606-573-6781
Practice Address - Street 1:8780 S US HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:CAWOOD
Practice Address - State:KY
Practice Address - Zip Code:40815-5218
Practice Address - Country:US
Practice Address - Phone:606-573-1069
Practice Address - Fax:606-573-6781
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY08-077235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist