MEDICARE: DR. CHERYL LYNN WEILL PH.D., MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	9630115	CO

General Provider Information

NPI Number	:	1376894303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL LYNN WEILL PH.D., MSW

Provider Business Mailing Address
First Line	:	2169 DOLAN ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-7092
Country	:	US
Telephone Number	:	970-556-9458
Fax Number	:

Provider Business Practice Location Address
First Line	:	2169 DOLAN ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-7092
Country	:	US
Telephone Number	:	970-556-9458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	10/01/2012

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