MEDICARE: MRS. CHERYL B. HAW CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2997154	WI

General Provider Information

NPI Number	:	1790901460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL B. HAW CCC-SLP

Provider Business Mailing Address
First Line	:	425 S WASHINGTON ST
Second Line	:
City	:	COMBINED LOCKS
State	:	WI
Zip	:	54113-1049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 S WASHINGTON ST
Second Line	:
City	:	COMBINED LOCKS
State	:	WI
Zip	:	54113-1049
Country	:	US
Telephone Number	:	920-788-7900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	05/29/2026

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