Provider Demographics
NPI:1588767800
Name:HOLDREDGE, CHERI SUSAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:SUSAN
Last Name:HOLDREDGE
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 1:205 LOCUST GROVE DR
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3281
Mailing Address - Country:US
Mailing Address - Phone:540-338-5085
Mailing Address - Fax:
Practice Address - Street 1:237 FAIRVIEW ST NW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2009
Practice Address - Country:US
Practice Address - Phone:540-687-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003331235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist