Provider Demographics
NPI:1275192569
Name:DELK, CHERYL ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:DELK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-4527
Mailing Address - Country:US
Mailing Address - Phone:405-372-2202
Mailing Address - Fax:580-215-5765
Practice Address - Street 1:110 N 4TH ST
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-4527
Practice Address - Country:US
Practice Address - Phone:405-372-2202
Practice Address - Fax:580-215-5765
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator