Provider Demographics
NPI:1679613103
Name:JEANNERET, CHERYL LYNN (QMHA)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYNN
Last Name:JEANNERET
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23338
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-0427
Mailing Address - Country:US
Mailing Address - Phone:541-686-1262
Mailing Address - Fax:541-686-0359
Practice Address - Street 1:1790 W. 11 STREET.
Practice Address - Street 2:SUITE 290 , SHELTERCARE
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-0427
Practice Address - Country:US
Practice Address - Phone:541-686-1262
Practice Address - Fax:541-686-0359
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health