MEDICARE: MRS. CHERI BENGE JONES M.A.

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	2378	NC

General Provider Information

NPI Number	:	1811905953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERI BENGE JONES M.A.

Provider Business Mailing Address
First Line	:	4401 FOREST HILLS DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-8062
Country	:	US
Telephone Number	:	704-542-2957
Fax Number	:	704-542-2957

Provider Business Practice Location Address
First Line	:	4401 FOREST HILLS DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-8062
Country	:	US
Telephone Number	:	704-542-2957
Fax Number	:	704-542-2957

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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