Basic Information
| Provider Information | |||||||||
| NPI: | 1801417787 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TALIAFERRO | ||||||||
| FirstName: | CHEYENNE | ||||||||
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| Credential: | MS, CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1241 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228024632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404341941 | ||||||||
| FaxNumber: | 5404340132 | ||||||||
| Practice Location | |||||||||
| Address1: | 463 E WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228024853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404333100 | ||||||||
| FaxNumber: | 5404340132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2020 | ||||||||
| LastUpdateDate: | 05/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2204000445 | VA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.