Provider Demographics
NPI:1962678284
Name:WINBORNE, CHERYL D (SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:D
Last Name:WINBORNE
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 1:5002 KENILWORTH DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4539
Mailing Address - Country:US
Mailing Address - Phone:318-742-8465
Mailing Address - Fax:
Practice Address - Street 1:5002 KENILWORTH DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-4539
Practice Address - Country:US
Practice Address - Phone:318-742-8465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist