Provider Demographics
NPI:1255115978
Name:CARAWAY, CHERILYN KAY (HIS)
Entity type:Individual
Prefix:
First Name:CHERILYN
Middle Name:KAY
Last Name:CARAWAY
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 1:522 US HIGHWAY 79 S, SUITE B
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75654
Mailing Address - Country:US
Mailing Address - Phone:903-657-1702
Mailing Address - Fax:
Practice Address - Street 1:522 US HIGHWAY 79 S, SUITE B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75654
Practice Address - Country:US
Practice Address - Phone:903-657-1702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81062237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist