Provider Demographics
NPI:1750466736
Name:DETTEN, CHERYL JOAN (PT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:JOAN
Last Name:DETTEN
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:12871 WESTHORPE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3736
Mailing Address - Country:US
Mailing Address - Phone:713-504-3442
Mailing Address - Fax:
Practice Address - Street 1:1431 GREENWAY DR STE 500
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2444
Practice Address - Country:US
Practice Address - Phone:713-783-8181
Practice Address - Fax:832-781-2001
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2024-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX11430972251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist