Provider Demographics
NPI:1841079019
Name:DEWITT, CHERILYN WYQUITA (BS)
Entity type:Individual
Prefix:MRS
First Name:CHERILYN
Middle Name:WYQUITA
Last Name:DEWITT
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
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Mailing Address - Street 1:3239 INDEPENDENCE RD
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-9380
Mailing Address - Country:US
Mailing Address - Phone:719-275-7650
Mailing Address - Fax:719-275-4209
Practice Address - Street 1:3239 INDEPENDENCE RD
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-9380
Practice Address - Country:US
Practice Address - Phone:719-275-7650
Practice Address - Fax:719-275-4209
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)