Provider Demographics
NPI:1134210495
Name:HENRY, CHERILYN ARMSTRONG (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHERILYN
Middle Name:ARMSTRONG
Last Name:HENRY
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 1:4324 W 20TH ST APT E230
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-1411
Mailing Address - Country:US
Mailing Address - Phone:850-914-9179
Mailing Address - Fax:850-914-9179
Practice Address - Street 1:502 N MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3654
Practice Address - Country:US
Practice Address - Phone:850-769-9008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7522235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA7522OtherDEPT OF HEALTH LICENSE