Provider Demographics
NPI:1194209916
Name:WIRFS, SHEILA MARIE (OT)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:WIRFS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20388 JUPITER WAY
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-7829
Mailing Address - Country:US
Mailing Address - Phone:952-210-9921
Mailing Address - Fax:
Practice Address - Street 1:1381 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-3080
Practice Address - Country:US
Practice Address - Phone:507-646-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102453225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist