Provider Demographics
NPI:1932291846
Name:KING, CHER LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHER
Middle Name:LYNN
Last Name:KING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:NONE
Other - Last Name:NONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:UT
Mailing Address - Zip Code:84340-0102
Mailing Address - Country:US
Mailing Address - Phone:801-726-7772
Mailing Address - Fax:435-734-1600
Practice Address - Street 1:3544 LINCOLN AVE STE G
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-4034
Practice Address - Country:US
Practice Address - Phone:801-726-7772
Practice Address - Fax:435-734-1600
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT931337722501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist