Provider Demographics
NPI:1427794098
Name:GWALTNEY, CHERYL
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:GWALTNEY
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 1:1644 ARNOLD AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-4527
Mailing Address - Country:US
Mailing Address - Phone:302-373-5324
Mailing Address - Fax:
Practice Address - Street 1:1159 BUNKER HILL RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9798
Practice Address - Country:US
Practice Address - Phone:302-373-5324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health