Provider Demographics
NPI:1497467724
Name:WILLIAMSON, CHERYL YVONNE
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:YVONNE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6611
Mailing Address - Country:US
Mailing Address - Phone:405-235-5671
Mailing Address - Fax:
Practice Address - Street 1:8112 S BLACKWELDER AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-5526
Practice Address - Country:US
Practice Address - Phone:405-953-2470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist