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General NPI Number Information
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NPI Number | 1760814313
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Entity Type | Individual
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Provider Name | CHERYL L MAHONEY
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Gender | Female
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 03/04/2017
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Provider Practice Location Address
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Address Line | 1900 COOLIDGE DR
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City | OAKWOOD
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State | OH
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Zip | 45419-2524
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Country | US
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Telephone | 937-673-3428
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Fax |
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Provider Business Mailing Address
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Address Line | 131 N LUDLOW ST 248
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City | DAYTON
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State | OH
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Zip | 45402-1116
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Country | US
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Telephone | 937-673-3428
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1000047
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License Number State | OH
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