Provider Demographics
NPI:1003423583
Name:LAWSON, SHEILA DIANE
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:DIANE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 TOWNSHIP ROAD 581
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:OH
Mailing Address - Zip Code:44880-9711
Mailing Address - Country:US
Mailing Address - Phone:440-915-2414
Mailing Address - Fax:
Practice Address - Street 1:58 TOWNSHIP ROAD 581
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:OH
Practice Address - Zip Code:44880-9711
Practice Address - Country:US
Practice Address - Phone:440-915-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care