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General NPI Number Information
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NPI Number | 1376797936
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Entity Type | Organization
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Legal Business Name | CHERYL COLVIN, PH.D., LLC
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 7650 RIVERS EDGE DR SUITE 140
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City | COLUMBUS
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State | OH
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Zip | 43235-1342
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Country | US
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Telephone | 614-848-5154
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Fax | 614-841-1957
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Provider Business Mailing Address
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Address Line | 7650 RIVERS EDGE DR SUITE 140
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City | COLUMBUS
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State | OH
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Zip | 43235-1342
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Country | US
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Telephone | 614-848-5154
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Fax | 614-841-1957
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | CHERYL COLVIN
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Credential | PH.D.
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Telephone | 614-848-5154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 5251
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License Number State | OH
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