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General NPI Number Information
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NPI Number | 1629401351
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Entity Type | Organization
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Legal Business Name | CHERYL N COLETTA PSY D PA
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 5301 N FEDERAL HWY STE 380
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City | BOCA RATON
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State | FL
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Zip | 33487-4916
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Country | US
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Telephone | 561-279-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 N FEDERAL HWY STE 380
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City | BOCA RATON
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State | FL
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Zip | 33487-4916
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Country | US
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Telephone | 561-279-5599
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CHERYL NANCY COLETTA
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Credential | PSY.D.
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Telephone | 561-279-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 8588
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License Number State | FL
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