Basic Information
| Provider Information | |||||||||
| NPI: | 1336365634 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEVE | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | B | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3705 WORCHESTER DR | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485034576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102130015 | ||||||||
| FaxNumber: | 8104968539 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 W WATER ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485035627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102130015 | ||||||||
| FaxNumber: | 8104968539 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 4704178431 | MI | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.