Provider Demographics
NPI:1437564390
Name:SHERIDAN, KRISTEN MICHELLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:MICHELLE
Other - Last Name:SPRINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1515 BETTE RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-2207
Mailing Address - Country:US
Mailing Address - Phone:315-527-0081
Mailing Address - Fax:
Practice Address - Street 1:1515 BETTE RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-2207
Practice Address - Country:US
Practice Address - Phone:315-527-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist