Provider Demographics
NPI:1073771333
Name:ZETTLE, CHERI ANN
Entity type:Individual
Prefix:MS
First Name:CHERI
Middle Name:ANN
Last Name:ZETTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 NE 4 AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064
Mailing Address - Country:US
Mailing Address - Phone:954-242-2543
Mailing Address - Fax:
Practice Address - Street 1:810 SE 8TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5623
Practice Address - Country:US
Practice Address - Phone:954-242-2543
Practice Address - Fax:954-725-7244
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP2578101YA0400X
FLMH6865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)