Provider Demographics
NPI:1346863867
Name:SHAFT, SHEENA N
Entity Type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:N
Last Name:SHAFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHEENA
Other - Middle Name:N
Other - Last Name:ELDRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5036 BARBARO CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3069
Mailing Address - Country:US
Mailing Address - Phone:502-321-9295
Mailing Address - Fax:
Practice Address - Street 1:5036 BARBARO CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3069
Practice Address - Country:US
Practice Address - Phone:502-321-9295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician