Provider Demographics
NPI:1760661706
Name:HAMANT ROSLUND, CHERYL E (LISW-S)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:E
Last Name:HAMANT ROSLUND
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7663 WASTLER RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45315-8972
Mailing Address - Country:US
Mailing Address - Phone:937-751-7196
Mailing Address - Fax:
Practice Address - Street 1:2211 ARBOR BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1521
Practice Address - Country:US
Practice Address - Phone:937-222-9481
Practice Address - Fax:937-222-3710
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-5269-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical