Provider Demographics
NPI:1225369184
Name:LITTLEJOHN, CHERIA JEANICE (MED)
Entity Type:Individual
Prefix:MISS
First Name:CHERIA
Middle Name:JEANICE
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13824 PAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1645
Mailing Address - Country:US
Mailing Address - Phone:405-642-5498
Mailing Address - Fax:
Practice Address - Street 1:13824 PAWNEE DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1645
Practice Address - Country:US
Practice Address - Phone:405-642-5498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health