MEDICARE: MRS. CHERYL ANNETTE BRANSCUM M.A., 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	SP#1342	AR
2	235Z00000X	Speech-Language Pathologist	3661	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104908920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL ANNETTE BRANSCUM M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	8839 BAINBRIDGE DR
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36526-8331
Country	:	US
Telephone Number	:	501-733-5270
Fax Number	:

Provider Business Practice Location Address
First Line	:	2115 HAND AVE
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-4149
Country	:	US
Telephone Number	:	251-937-2823
Fax Number	:	251-937-2821

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	06/24/2015

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Directions to “ MRS. CHERYL ANNETTE BRANSCUM M.A., CCC-SLP” Practice Location

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