Provider Demographics
NPI:1497226195
Name:DAVIS, SHEILA DAWN
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:DAWN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-3357
Mailing Address - Country:US
Mailing Address - Phone:443-610-2139
Mailing Address - Fax:
Practice Address - Street 1:12 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3657
Practice Address - Country:US
Practice Address - Phone:410-763-6823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider