Provider Demographics
NPI:1063926756
Name:DANN, CHERYL SUE (MSW)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:SUE
Last Name:DANN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:SUE
Other - Last Name:MOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 712
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649
Mailing Address - Country:US
Mailing Address - Phone:231-818-7907
Mailing Address - Fax:
Practice Address - Street 1:2283 M-113 E
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:MI
Practice Address - Zip Code:49649
Practice Address - Country:US
Practice Address - Phone:231-818-7907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010589391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical