MEDICARE: MRS. CHERYL KLEIN 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	TSLP6415	AZ

General Provider Information

NPI Number	:	1881928448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL KLEIN SLP

Provider Business Mailing Address
First Line	:	3426 E SHEA BLVD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3327
Country	:	US
Telephone Number	:	602-224-0598
Fax Number	:	602-224-2460

Provider Business Practice Location Address
First Line	:	3426 E SHEA BLVD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3327
Country	:	US
Telephone Number	:	602-224-0598
Fax Number	:	602-224-2460

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

Provider Enumeration Date	:	09/29/2009
Last Update Date	:	09/29/2009

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