Provider Demographics
NPI:1811307986
Name:BEVIS, CHERYL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BEVIS
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 1:2908 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3330
Mailing Address - Country:US
Mailing Address - Phone:320-894-8746
Mailing Address - Fax:
Practice Address - Street 1:515 COLLEGE RD STE 13
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5150
Practice Address - Country:US
Practice Address - Phone:336-446-9237
Practice Address - Fax:877-540-0370
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9202235Z00000X
NC13865235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist