Provider Demographics
NPI:1841345931
Name:GWIN, CHERI RENEE (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:RENEE
Last Name:GWIN
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 INDIANOLA RD
Mailing Address - Street 2:
Mailing Address - City:CHESWICK
Mailing Address - State:PA
Mailing Address - Zip Code:15024-4012
Mailing Address - Country:US
Mailing Address - Phone:412-708-2080
Mailing Address - Fax:
Practice Address - Street 1:210 INDIANOLA RD
Practice Address - Street 2:
Practice Address - City:CHESWICK
Practice Address - State:PA
Practice Address - Zip Code:15024
Practice Address - Country:US
Practice Address - Phone:412-708-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006089L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist