Provider Demographics
NPI:1265739783
Name:WOLBERT, CHERYL LYNN
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:WOLBERT
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 1:4184 WINNERS CIR
Mailing Address - Street 2:1913
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1748 INDEPENDENCE BLVD
Practice Address - Street 2:E-7
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2122
Practice Address - Country:US
Practice Address - Phone:941-359-1927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor