Provider Demographics
NPI:1932510526
Name:WOLFF, CHERYL (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:WOLFF
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 1:3338 LAKE VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8374
Mailing Address - Country:US
Mailing Address - Phone:321-255-9219
Mailing Address - Fax:
Practice Address - Street 1:3338 LAKE VIEW CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-8374
Practice Address - Country:US
Practice Address - Phone:321-255-9219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist