Provider Demographics
NPI:1831884501
Name:COMFORT, CHERYL RAYE
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:RAYE
Last Name:COMFORT
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 1:803 N WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-2357
Mailing Address - Country:US
Mailing Address - Phone:940-206-9415
Mailing Address - Fax:
Practice Address - Street 1:803 N. WRIGHT ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-2357
Practice Address - Country:US
Practice Address - Phone:940-206-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2209024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health