Basic Information
Provider Information
NPI: 1972760239
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEAL
FirstName: SHERYL
MiddleName: DEE
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7147 VISTA DR STE 150
Address2:  
City: WEST DES MOINES
State: IA
PostalCode: 502669313
CountryCode: US
TelephoneNumber: 5158759925
FaxNumber: 5158759923
Practice Location
Address1: 5950 UNIVERSITY AVE
Address2: STE 265
City: WEST DES MOINES
State: IA
PostalCode: 50266
CountryCode: US
TelephoneNumber: 5158759450
FaxNumber: 5158759457
Other Information
ProviderEnumerationDate: 05/22/2008
LastUpdateDate: 06/22/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X368IAN Speech, Language and Hearing Service ProvidersAudiologist 
231H00000X219IAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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