Provider Demographics
NPI:1518115021
Name:DUSSAULT, CHERI BEHRNS (GCFP)
Entity Type:Individual
Prefix:MS
First Name:CHERI
Middle Name:BEHRNS
Last Name:DUSSAULT
Suffix:
Gender:F
Credentials:GCFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 EAST MONUMENT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903
Mailing Address - Country:US
Mailing Address - Phone:719-633-9861
Mailing Address - Fax:719-634-3474
Practice Address - Street 1:130 EAST MONUMENT
Practice Address - Street 2:SUITE 101
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903
Practice Address - Country:US
Practice Address - Phone:719-633-9861
Practice Address - Fax:719-634-3474
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist