Provider Demographics
NPI:1093927477
Name:DEROIN, CHERYL MARIE (NMD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:MARIE
Last Name:DEROIN
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8390 E VIA DE VENTURA
Mailing Address - Street 2:SUITE F-111
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3188
Mailing Address - Country:US
Mailing Address - Phone:480-951-0111
Mailing Address - Fax:480-951-6505
Practice Address - Street 1:8390 E VIA DE VENTURA
Practice Address - Street 2:SUITE F-111
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3188
Practice Address - Country:US
Practice Address - Phone:480-951-0111
Practice Address - Fax:480-951-6505
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01-611175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath