Doctor Name: | CHERRY DOLPH |
NPI Number: | 1194079434 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.C. |
License Number: | C1100026 |
Business Practice Address: | 202 E Bagley Rd Berea, OH - 440172058 |
Business Phone Number: | 4402608453 |
Business Fax Number: | |
Mailing Address: | 465 Park Ave Sw, BOLIVAR |
State: | OH |
Postal Code: | 446129723 |
Phone Number: | 3302323977 |
Fax Number: | |
NPI Enumeration Date: | 11/08/2012 |
NPI Last Update Date: | 11/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C1100026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |