Provider Demographics
NPI:1386013878
Name:FLANAGAN, CHERISSE (PHD)
Entity Type:Individual
Prefix:
First Name:CHERISSE
Middle Name:
Last Name:FLANAGAN
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 1:1502 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-5602
Mailing Address - Country:US
Mailing Address - Phone:325-672-9999
Mailing Address - Fax:325-672-5237
Practice Address - Street 1:1502 N 1ST ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5602
Practice Address - Country:US
Practice Address - Phone:325-672-9999
Practice Address - Fax:325-672-5237
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical