Provider Demographics
NPI:1619001450
Name:MILLIGAN, CHERAY LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHERAY
Middle Name:LYNN
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CACTUS RD
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-5706
Mailing Address - Country:US
Mailing Address - Phone:505-721-1806
Mailing Address - Fax:
Practice Address - Street 1:202 CACTUS RD
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5706
Practice Address - Country:US
Practice Address - Phone:505-721-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant