Healthcare Provider Details
I. General information
NPI: 1316577653
Provider Name (Legal Business Name): CHERISH HARVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/24/2020
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
735 S 200 W STE 1
BLANDING UT
84511-3923
US
IV. Provider business mailing address
735 S 200 W STE 1
BLANDING UT
84511-3923
US
V. Phone/Fax
- Phone: 435-678-2992
- Fax: 435-678-3116
- Phone: 435-678-2992
- Fax: 435-678-3116
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: