Provider Demographics
NPI:1780402867
Name:WORRELL, CHERYL J (LMT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:J
Last Name:WORRELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 E SHAFFER DR
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1012
Mailing Address - Country:US
Mailing Address - Phone:412-616-9358
Mailing Address - Fax:
Practice Address - Street 1:4002 E SHAFFER DR
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1012
Practice Address - Country:US
Practice Address - Phone:412-616-9358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG009684225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist