Provider Demographics
NPI:1407840192
Name:HENSLEY, SHERRILL A (OT)
Entity Type:Individual
Prefix:
First Name:SHERRILL
Middle Name:A
Last Name:HENSLEY
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 1:3160 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1083
Mailing Address - Country:US
Mailing Address - Phone:419-841-1840
Mailing Address - Fax:419-841-1841
Practice Address - Street 1:3160 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1083
Practice Address - Country:US
Practice Address - Phone:419-841-1840
Practice Address - Fax:419-841-1841
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.003448225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2129655Medicaid