Provider Demographics
NPI:1659670636
Name:HAINEY, SHEILA KAY (PTA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:KAY
Last Name:HAINEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:KAY
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:76 SHORT ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-6114
Mailing Address - Country:US
Mailing Address - Phone:606-679-1291
Mailing Address - Fax:
Practice Address - Street 1:2150 LEXINGTON RD STE G
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7924
Practice Address - Country:US
Practice Address - Phone:859-333-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA01278225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant