Provider Demographics
NPI:1770035743
Name:RUBENSTEIN, CHERYL (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 GIDDINGS AVE
Mailing Address - Street 2:SUITE 33
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1418
Mailing Address - Country:US
Mailing Address - Phone:301-461-1717
Mailing Address - Fax:
Practice Address - Street 1:716 GIDDINGS AVE
Practice Address - Street 2:SUITE 33
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1418
Practice Address - Country:US
Practice Address - Phone:301-461-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04510103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist