Provider Demographics
NPI:1134553035
Name:CHESSER, CHERYL RENEE
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:RENEE
Last Name:CHESSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 HIGHWAY AVE
Mailing Address - Street 2:101
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-3694
Mailing Address - Country:US
Mailing Address - Phone:904-703-7774
Mailing Address - Fax:904-683-8169
Practice Address - Street 1:5251 HIGHWAY AVE
Practice Address - Street 2:101
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32254-3694
Practice Address - Country:US
Practice Address - Phone:904-703-7774
Practice Address - Fax:904-683-8169
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health