Individual
CHERYL ANNE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
(585) 377-2243
Mailing address
257 ALVERSTONE WAY, WEST HENRIETTA, NY 14586-9581
(716) 867-9021
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14028500
NY
Other
Enumeration date
09/12/2012
Last updated
10/18/2012
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