Healthcare Provider Details

I. General information

NPI: 1285730143
Provider Name (Legal Business Name): CHERYL THOMAS KUHN MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S2415 CONADA RIDGE ROAD
FOUNTAIN CITY WI
54629
US

IV. Provider business mailing address

S2415 CONADA RIDGE ROAD
FOUNTAIN CITY WI
54629
US

V. Phone/Fax

Practice location:
  • Phone: 608-687-7300
  • Fax: 608-687-7300
Mailing address:
  • Phone: 608-687-7300
  • Fax: 608-687-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2483 154
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7738
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: