Provider Demographics
NPI:1477619112
Name:HENRICHS, SHEILA JANE (PT)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:JANE
Last Name:HENRICHS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4904
Mailing Address - Country:US
Mailing Address - Phone:715-298-2060
Mailing Address - Fax:
Practice Address - Street 1:3312 TERRACE CT
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4904
Practice Address - Country:US
Practice Address - Phone:715-298-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10379-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist