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CHERYL ENSOM DACK
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1386084606
Individual Registrant: CHERYL ENSOM DACK
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
40 E MINARETS AVE PINEDALE, CA 93650-1239 US
Tel: 559-436-0482 Fax: --
Tel: 559-436-0482 Fax: --
Contact information for business:
85 W LARSEN AVE FRESNO, CA 93706-6035 US
Tel: 559-999-3528 Fax: --
Tel: 559-999-3528 Fax: --
Registration Information:
NPI: 1386084606
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
