Provider Demographics
NPI:1033105069
Name:MARTIN, CHERYL WEINERT (EDD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:WEINERT
Last Name:MARTIN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 E PIMA ST
Mailing Address - Street 2:STE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4370
Mailing Address - Country:US
Mailing Address - Phone:520-886-8500
Mailing Address - Fax:520-749-3193
Practice Address - Street 1:5930 E PIMA ST
Practice Address - Street 2:STE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4370
Practice Address - Country:US
Practice Address - Phone:520-886-8500
Practice Address - Fax:520-749-3193
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2009-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional