Provider Demographics
NPI:1710875794
Name:TITUS, CHERICE LATAY (PP)
Entity type:Individual
Prefix:
First Name:CHERICE
Middle Name:LATAY
Last Name:TITUS
Suffix:
Gender:F
Credentials:PP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 US HIGHWAY 319 N LOT 46
Mailing Address - Street 2:
Mailing Address - City:NORMAN PARK
Mailing Address - State:GA
Mailing Address - Zip Code:31771-6121
Mailing Address - Country:US
Mailing Address - Phone:229-319-5956
Mailing Address - Fax:
Practice Address - Street 1:1330 US HIGHWAY 319 N LOT 46
Practice Address - Street 2:
Practice Address - City:NORMAN PARK
Practice Address - State:GA
Practice Address - Zip Code:31771-6121
Practice Address - Country:US
Practice Address - Phone:229-319-5956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician