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Individual

CHERYL SHOOK

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CADC

Contact information

Practice address
1311 N DIXIE HWY, ELIZABETHTOWN, KY 42701-2621
(270) 769-1304
(270) 234-8028
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 766-1222

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0839
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11576761
CAQH
05
30605018
KY
Enumeration date
06/09/2006
Last updated
07/08/2007
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