Provider Demographics
NPI:1477685469
Name:SHELDEN, TERESA ANN (OTR)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:SHELDEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16784 N NORMAN RD
Mailing Address - Street 2:
Mailing Address - City:LEAD HILL
Mailing Address - State:AR
Mailing Address - Zip Code:72644-9808
Mailing Address - Country:US
Mailing Address - Phone:870-436-4161
Mailing Address - Fax:
Practice Address - Street 1:16784 N NORMAN RD
Practice Address - Street 2:
Practice Address - City:LEAD HILL
Practice Address - State:AR
Practice Address - Zip Code:72644-9808
Practice Address - Country:US
Practice Address - Phone:870-436-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR797225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist