Provider Demographics
NPI:1598191355
Name:DE CASTRO, SHEILA MAY HANDUMON (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA MAY
Middle Name:HANDUMON
Last Name:DE CASTRO
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 1:570 CHURCH ST E
Mailing Address - Street 2:APT 703
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4697
Mailing Address - Country:US
Mailing Address - Phone:615-457-3980
Mailing Address - Fax:
Practice Address - Street 1:1600 W AVENUE I
Practice Address - Street 2:
Practice Address - City:LOVINGTON
Practice Address - State:NM
Practice Address - Zip Code:88260-5002
Practice Address - Country:US
Practice Address - Phone:402-301-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist