Provider Demographics
NPI:1528271251
Name:GECKLER, CHERI LOU (PHD)
Entity type:Individual
Prefix:DR
First Name:CHERI
Middle Name:LOU
Last Name:GECKLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 LAKE AVE
Mailing Address - Street 2:APT. 1910
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1576
Mailing Address - Country:US
Mailing Address - Phone:216-462-0522
Mailing Address - Fax:
Practice Address - Street 1:6611 ROCKSIDE RD
Practice Address - Street 2:215
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2365
Practice Address - Country:US
Practice Address - Phone:216-462-0522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4513103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist