Provider Demographics
NPI:1235572025
Name:BAHR, SHEILA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:BAHR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4283 CARIBOU LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55810-9762
Mailing Address - Country:US
Mailing Address - Phone:218-340-7644
Mailing Address - Fax:
Practice Address - Street 1:4801 BURNING TREE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3801
Practice Address - Country:US
Practice Address - Phone:218-340-7644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102066225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics