Provider Demographics
NPI:1194128389
Name:AFFRUNTI, CHERYL LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LEE
Last Name:AFFRUNTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1767 LAKEWOOD RANCH BLVD # 248
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4906
Mailing Address - Country:US
Mailing Address - Phone:941-248-6987
Mailing Address - Fax:217-787-3232
Practice Address - Street 1:13062 BLISS LOOP
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-4069
Practice Address - Country:US
Practice Address - Phone:941-248-6987
Practice Address - Fax:217-787-3232
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical