Provider Demographics
NPI:1093283921
Name:GREENE, CHERI (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COOPER LN
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-2959
Mailing Address - Country:US
Mailing Address - Phone:865-453-4747
Mailing Address - Fax:
Practice Address - Street 1:6 COOPER LN
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-2959
Practice Address - Country:US
Practice Address - Phone:828-678-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5601225XP0019X
TN6186225XP0019X
NC13526225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13526OtherSTATE LICENSE