Provider Demographics
NPI:1053753731
Name:SCHALLER, SHERYL
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2162 YELLOWSTONE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2252
Mailing Address - Country:US
Mailing Address - Phone:303-727-0209
Mailing Address - Fax:
Practice Address - Street 1:519 EMERY ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5544
Practice Address - Country:US
Practice Address - Phone:303-702-0091
Practice Address - Fax:303-702-0108
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist