Provider Demographics
NPI:1205932563
Name:CITRON, CHERYL CORCORAN (PHD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:CORCORAN
Last Name:CITRON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1540 SUNDAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6000
Mailing Address - Country:US
Mailing Address - Phone:919-859-9040
Mailing Address - Fax:919-859-9030
Practice Address - Street 1:1540 SUNDAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6000
Practice Address - Country:US
Practice Address - Phone:919-859-9040
Practice Address - Fax:919-859-9030
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1054103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist