Provider Demographics
NPI:1053154302
Name:CHERILLA, HALEY (AUD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:CHERILLA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 OAKWOOD AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2636
Mailing Address - Country:US
Mailing Address - Phone:814-641-4327
Mailing Address - Fax:814-641-7104
Practice Address - Street 1:100 OAKWOOD AVE STE 400
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2636
Practice Address - Country:US
Practice Address - Phone:814-641-4327
Practice Address - Fax:814-641-7104
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006964231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist