Provider Demographics
NPI:1841253671
Name:CERRA, PATRICK FRANK (EDD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:FRANK
Last Name:CERRA
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E PUGH DR
Mailing Address - Street 2:SUITE #14
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-3942
Mailing Address - Country:US
Mailing Address - Phone:812-238-9221
Mailing Address - Fax:812-235-0571
Practice Address - Street 1:1400 E PUGH DR
Practice Address - Street 2:SUITE #14
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-3942
Practice Address - Country:US
Practice Address - Phone:812-238-9221
Practice Address - Fax:812-235-0571
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20090112103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist