Provider Demographics
NPI:1093849887
Name:WAFER, CHERONDA TRENA (LBSW)
Entity Type:Individual
Prefix:MS
First Name:CHERONDA
Middle Name:TRENA
Last Name:WAFER
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5668 W LITTLE YORK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-1116
Mailing Address - Country:US
Mailing Address - Phone:281-447-2800
Mailing Address - Fax:281-447-6688
Practice Address - Street 1:3737 RED BLUFF RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77503-3307
Practice Address - Country:US
Practice Address - Phone:713-740-5023
Practice Address - Fax:713-740-5110
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38847104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker