Provider Demographics
NPI:1912731571
Name:SPEARMAN-MATHERLY, CHEYENNE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:SPEARMAN-MATHERLY
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 HAWTHORNE BLVD STE 1000
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6834
Mailing Address - Country:US
Mailing Address - Phone:310-901-4345
Mailing Address - Fax:310-792-2878
Practice Address - Street 1:25500 HAWTHORNE BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6834
Practice Address - Country:US
Practice Address - Phone:310-901-4345
Practice Address - Fax:310-792-2878
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-24-74738103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst