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General NPI Number Information
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NPI Number | 1669707782
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Entity Type | Organization
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Legal Business Name | DR HEIDI CHERWONY, PA
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 5458 TOWN CENTER RD SUITE 104
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City | BOCA RATON
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State | FL
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Zip | 33486-1089
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Country | US
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Telephone | 561-699-4639
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Fax |
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Provider Business Mailing Address
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Address Line | 8846 SONOMA LAKE BLVD
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City | BOCA RATON
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State | FL
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Zip | 33434-4069
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Country | US
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Telephone | 561-699-4639
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HEIDI R CHERWONY
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Credential | PSYD
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Telephone | 561-699-4639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6812
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License Number State | FL
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