Provider Demographics
NPI:1114125218
Name:ZEHR, SHEILA BROOKE (COTA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:BROOKE
Last Name:ZEHR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:BROOKE
Other - Last Name:PURUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:1716 MAPLEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-7012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 MOREHOUSE AVE
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-2552
Practice Address - Country:US
Practice Address - Phone:574-295-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001362A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant