Provider Demographics
NPI:1235905738
Name:MILCAREK, CHERYL JEAN (COTA/L)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:JEAN
Last Name:MILCAREK
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 MIDDLE GIBBS RD
Mailing Address - Street 2:
Mailing Address - City:KNOTTS ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27950-9749
Mailing Address - Country:US
Mailing Address - Phone:757-775-8913
Mailing Address - Fax:
Practice Address - Street 1:776 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3728
Practice Address - Country:US
Practice Address - Phone:757-389-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002198224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant