Provider Demographics
NPI:1154634657
Name:FITZSIMMONS, CHERYL ELIZABETH (MA)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ELIZABETH
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14985 PRISTINE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3545
Mailing Address - Country:US
Mailing Address - Phone:719-510-8189
Mailing Address - Fax:719-527-9828
Practice Address - Street 1:14985 PRISTINE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3545
Practice Address - Country:US
Practice Address - Phone:719-510-8189
Practice Address - Fax:719-527-9828
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0442122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist