Doctor Name: | MS. CHERYL N MOFFATT |
NPI Number: | 1871831776 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC6053 |
Business Practice Address: | 350 Derbyshire Lane Riva, MD - 21140 |
Business Phone Number: | 4105620327 |
Business Fax Number: | |
Mailing Address: | 350 Derbyshire Ln, RIVA |
State: | MD |
Postal Code: | 211401511 |
Phone Number: | 4105620327 |
Fax Number: | |
NPI Enumeration Date: | 01/28/2013 |
NPI Last Update Date: | 11/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LC6053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |