Provider Demographics
NPI:1750415022
Name:CAMPBELL, CHERYL (MS)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 QUAIL WEST DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8014
Mailing Address - Country:US
Mailing Address - Phone:859-576-1820
Mailing Address - Fax:866-299-7212
Practice Address - Street 1:273 QUAIL WEST DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8014
Practice Address - Country:US
Practice Address - Phone:859-576-1820
Practice Address - Fax:866-299-7212
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1957235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist