Individual
MS. CHERYL LEE SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED. TVI
Contact information
Practice address
4635 UNION RD, CHEEKTOWAGA, NY 14225-1851
(716) 505-5700
(716) 633-9351
Mailing address
4635 UNION RD, CHEEKTOWAGA, NY 14225-1851
(716) 505-5700
(716) 633-9351
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12345
NY
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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