Provider Demographics
NPI:1699815605
Name:PENDERGRASS, CHERYL (MS, CGC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:PENDERGRASS
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:JOHNS HOPKINS UNIVERSITY REED HALL WEST, RM 306A
Practice Address - Street 2:1620 MCELDERRY ST.
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1904
Practice Address - Country:US
Practice Address - Phone:410-614-8667
Practice Address - Fax:
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
Yes170300000XOther Service ProvidersGenetic Counselor, MS