Provider Demographics
NPI:1821859315
Name:CHER, MAXINE (MS)
Entity Type:Individual
Prefix:
First Name:MAXINE
Middle Name:
Last Name:CHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 BLACK FOREST RD
Mailing Address - Street 2:
Mailing Address - City:GLEN SPEY
Mailing Address - State:NY
Mailing Address - Zip Code:12737-8507
Mailing Address - Country:US
Mailing Address - Phone:267-205-7639
Mailing Address - Fax:
Practice Address - Street 1:16445 COLLINS AVE APT 1224
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4560
Practice Address - Country:US
Practice Address - Phone:267-205-7639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT3690106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist