Provider Demographics
NPI:1871615948
Name:AKRIDGE, CHERYL ANN (DEVELOPEMENTAL THERA)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:AKRIDGE
Suffix:
Gender:F
Credentials:DEVELOPEMENTAL THERA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4934 E COUNTY ROAD 100 N
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8616
Mailing Address - Country:US
Mailing Address - Phone:317-625-4971
Mailing Address - Fax:317-745-6152
Practice Address - Street 1:4934 E COUNTY ROAD 100 N
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8616
Practice Address - Country:US
Practice Address - Phone:317-625-4971
Practice Address - Fax:317-745-6152
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN222Q00000X222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist