Provider Demographics
NPI:1609192046
Name:STINSON, CHERYL (SLP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:STINSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 S CLAYTON CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3483
Mailing Address - Country:US
Mailing Address - Phone:720-331-6098
Mailing Address - Fax:
Practice Address - Street 1:8015 S CLAYTON CIR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3483
Practice Address - Country:US
Practice Address - Phone:720-331-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2015-12-30
Deactivation Date:2012-06-12
Deactivation Code:
Reactivation Date:2015-12-30
Provider Licenses
StateLicense IDTaxonomies
CO12051056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12051056OtherCERTIFICATE OF CLINICAL COMPETENCE - AMERICAN SPEECH-LANGUAGE-HEARING ASSOC.