Healthcare Provider Details

I. General information

NPI: 1225949423
Provider Name (Legal Business Name): MISS CHERI A WORRALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21228 NEWCASTLE RD
HARPER WOODS MI
48225-2313
US

IV. Provider business mailing address

21228 NEWCASTLE RD
HARPER WOODS MI
48225-2313
US

V. Phone/Fax

Practice location:
  • Phone: 810-775-7035
  • Fax:
Mailing address:
  • Phone: 810-775-7035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number87206
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: