Provider Demographics
NPI:1144645607
Name:PRO, CHERIE (MSW)
Entity type:Individual
Prefix:
First Name:CHERIE
Middle Name:
Last Name:PRO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14819 QUEZADA WAY
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-2288
Mailing Address - Country:US
Mailing Address - Phone:661-250-0819
Mailing Address - Fax:
Practice Address - Street 1:14819 QUEZADA WAY
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-2288
Practice Address - Country:US
Practice Address - Phone:661-250-0819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner