Provider Demographics
NPI:1750939559
Name:DRISKELL, CHERYL MARIA X
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:MARIA
Last Name:DRISKELL
Suffix:X
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 1:2102 BEVERLEY RD APT 2L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3935
Mailing Address - Country:US
Mailing Address - Phone:347-845-8342
Mailing Address - Fax:
Practice Address - Street 1:2102 BEVERLEY RD APT 2L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3935
Practice Address - Country:US
Practice Address - Phone:347-845-8342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst