Provider Demographics
NPI:1285314963
Name:ADKINS, CHERYL L
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:ADKINS
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 1:11846 NEWBERRY GROVE LOOP
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-3905
Mailing Address - Country:US
Mailing Address - Phone:518-364-3995
Mailing Address - Fax:
Practice Address - Street 1:11846 NEWBERRY GROVE LOOP
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-3905
Practice Address - Country:US
Practice Address - Phone:518-364-3995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1442951103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool