Provider Demographics
NPI:1467854166
Name:TREASURE-MYLES, CHERYL T (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:T
Last Name:TREASURE-MYLES
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 VILLAGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1136
Mailing Address - Country:US
Mailing Address - Phone:516-481-2483
Mailing Address - Fax:516-481-2483
Practice Address - Street 1:1270 VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1136
Practice Address - Country:US
Practice Address - Phone:516-481-2483
Practice Address - Fax:516-481-2483
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348554091174H00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No252Y00000XAgenciesEarly Intervention Provider Agency