Provider Demographics
NPI:1972156115
Name:TICE, CHERYL-ROSE (RBT)
Entity type:Individual
Prefix:
First Name:CHERYL-ROSE
Middle Name:
Last Name:TICE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 AVENUE J
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-5146
Mailing Address - Country:US
Mailing Address - Phone:830-693-0530
Mailing Address - Fax:830-637-7438
Practice Address - Street 1:606 AVENUE J
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5146
Practice Address - Country:US
Practice Address - Phone:830-693-0530
Practice Address - Fax:830-637-7438
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist