Provider Demographics
NPI:1578272019
Name:WARD, SHEILA JJ
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:JJ
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:JJ
Other - Last Name:WARD LANGIDRIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 E 3RD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-2563
Mailing Address - Country:US
Mailing Address - Phone:541-705-4903
Mailing Address - Fax:
Practice Address - Street 1:401 E 3RD ST STE 101
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-2563
Practice Address - Country:US
Practice Address - Phone:541-705-4903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician