Provider Demographics
NPI:1790834992
Name:COLE, CHEER BEULAH (MS OTRL)
Entity Type:Individual
Prefix:MRS
First Name:CHEER
Middle Name:BEULAH
Last Name:COLE
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 SHIRK ROAD
Mailing Address - Street 2:
Mailing Address - City:MILLMONT
Mailing Address - State:PA
Mailing Address - Zip Code:17845
Mailing Address - Country:US
Mailing Address - Phone:570-922-4311
Mailing Address - Fax:
Practice Address - Street 1:889 FAIRGROUND ROAD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837
Practice Address - Country:US
Practice Address - Phone:570-524-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0C007192L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist