Provider Demographics
NPI:1063847762
Name:JOINER, CHERRILLEYE
Entity Type:Individual
Prefix:
First Name:CHERRILLEYE
Middle Name:
Last Name:JOINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 NW 4TH ST APT K22
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-6967
Mailing Address - Country:US
Mailing Address - Phone:580-284-4779
Mailing Address - Fax:
Practice Address - Street 1:305 NW 4TH ST APT K22
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-6967
Practice Address - Country:US
Practice Address - Phone:580-284-4779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator