Provider Demographics
NPI:1609125277
Name:HENDRY, CHERYL LEE (APC)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LEE
Last Name:HENDRY
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1862 E 1900 N
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-2223
Mailing Address - Country:US
Mailing Address - Phone:801-698-5015
Mailing Address - Fax:801-444-0982
Practice Address - Street 1:1140 36TH ST STE 202
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2093
Practice Address - Country:US
Practice Address - Phone:801-392-0004
Practice Address - Fax:801-392-2618
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7259819-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health