MEDICARE: MS. CHERYL ELAINE HEFLIN 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.1130	OH

General Provider Information

NPI Number	:	1427238609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHERYL ELAINE HEFLIN SLP

Provider Business Mailing Address
First Line	:	563 HEATHER DR
Second Line	:	#3A
City	:	DAYTON
State	:	OH
Zip	:	45405-1739
Country	:	US
Telephone Number	:	937-276-2801
Fax Number	:

Provider Business Practice Location Address
First Line	:	563 HEATHER DR
Second Line	:	#3A
City	:	DAYTON
State	:	OH
Zip	:	45405-1739
Country	:	US
Telephone Number	:	937-276-2801
Fax Number	:

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

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/26/2007

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