Provider Demographics
NPI:1912914813
Name:PATTERSON, CHERYL BETH (PTA)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:BETH
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5628 CRESCENT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1149
Mailing Address - Country:US
Mailing Address - Phone:410-256-5231
Mailing Address - Fax:
Practice Address - Street 1:9101 FRANKLIN SQUARE DR STE 205
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3975
Practice Address - Country:US
Practice Address - Phone:443-777-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2994225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant