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General NPI Number Information
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NPI Number | 1225460108
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Entity Type | Individual
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Provider Name | CHERYL PLANK
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Gender | Female
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 04/07/2021
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Provider Practice Location Address
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Address Line | 300 GOVERNORS HWY
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-2422
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Country | US
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Telephone | 860-996-0031
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 2559
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City | HEBRON
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State | CT
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Zip | 06248
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Country | US
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Telephone | 860-494-3800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 011252
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License Number State | CT
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