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General NPI Number Information
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NPI Number | 1528319712
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Entity Type | Individual
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Provider Name | CHERYL PULVIRENTI M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2012
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 2995 E GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48202-3133
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Country | US
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Telephone | 586-718-0390
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 28
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City | NEW BALTIMORE
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State | MI
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Zip | 48047-0028
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Country | US
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Telephone | 586-718-0390
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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