Provider Demographics
NPI:1780711671
Name:RIVER, CHERIE LYNN (MS-CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHERIE
Middle Name:LYNN
Last Name:RIVER
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 SAXONBURG BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-3160
Mailing Address - Country:US
Mailing Address - Phone:412-767-5967
Mailing Address - Fax:
Practice Address - Street 1:3394 SAXONBURG BLVD
Practice Address - Street 2:SUITE 620
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-3168
Practice Address - Country:US
Practice Address - Phone:412-767-5967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006123L235Z00000X
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020417940002Medicaid
PA1020417940002Medicaid