Provider Demographics
NPI:1609284835
Name:ROWAN, CHERYL CONLY (MA-SLP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:CONLY
Last Name:ROWAN
Suffix:
Gender:F
Credentials:MA-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2298
Mailing Address - Country:US
Mailing Address - Phone:818-427-3600
Mailing Address - Fax:
Practice Address - Street 1:315 WALNUT LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2298
Practice Address - Country:US
Practice Address - Phone:818-427-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO140670235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist