Individual
CHERYL ENSOM DACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 E MINARETS AVE, PINEDALE, CA 93650-1239
(559) 436-0482
Mailing address
85 W LARSEN AVE, FRESNO, CA 93706-6035
(559) 999-3528
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/01/2013
Last updated
07/05/2013
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