Provider Demographics
NPI:1639296726
Name:CHERRY, TANYA LYNN
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:LYNN
Last Name:CHERRY
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 1:201 UFFELMAN DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2975
Mailing Address - Country:US
Mailing Address - Phone:931-920-7330
Mailing Address - Fax:
Practice Address - Street 1:201 UFFELMAN DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2975
Practice Address - Country:US
Practice Address - Phone:931-920-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist