MEDICARE: DR. VALERIE CHERRY PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY5698	FL

General Provider Information

NPI Number	:	1063660132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIE CHERRY PH.D.

Provider Business Mailing Address
First Line	:	5006 WAYDALE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2733
Country	:	US
Telephone Number	:	813-267-7183
Fax Number	:

Provider Business Practice Location Address
First Line	:	5006 WAYDALE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2733
Country	:	US
Telephone Number	:	813-267-7183
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	03/06/2014

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