Provider Demographics
NPI:1336251750
Name:DESMOND-MAY, CHERI ANN (MSW, MAED, LP)
Entity Type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:ANN
Last Name:DESMOND-MAY
Suffix:
Gender:F
Credentials:MSW, MAED, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2908
Mailing Address - Country:US
Mailing Address - Phone:612-722-3304
Mailing Address - Fax:
Practice Address - Street 1:2301 COMO AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1718
Practice Address - Country:US
Practice Address - Phone:651-698-0508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0130103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN09G30ANOtherBCBS PROVIDER #