Provider Demographics
NPI:1609307511
Name:WARD, CHERYL MARIE (HIS)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 SHALLOWFORD RD
Mailing Address - Street 2:STE 104
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1616
Mailing Address - Country:US
Mailing Address - Phone:423-894-1133
Mailing Address - Fax:423-894-0292
Practice Address - Street 1:6151 SHALLOWFORD RD
Practice Address - Street 2:STE 104
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1616
Practice Address - Country:US
Practice Address - Phone:423-894-1133
Practice Address - Fax:423-894-0292
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN879237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist