Individual
DR. CHERYL HETHERINGTON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD.
Contact information
Practice address
123 N LINN ST, SUITE 2D, IOWA CITY, IA 52245-2143
(319) 337-9461
(319) 339-8061
Mailing address
123 N LINN ST, SUITE 2D, IOWA CITY, IA 52245-2143
(319) 337-9461
(319) 339-8061
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
486
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
322
HEALTH SERVICE PROVIDER
IA
01
—
52714
WELLMARK PROVIDER NUMBER
IA
01
—
68009314
RR MEDICARE
IA
Enumeration date
01/27/2006
Last updated
07/08/2007
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