Provider Demographics
NPI:1689871287
Name:BECKORT, SHERA KAY (OTR)
Entity Type:Individual
Prefix:MISS
First Name:SHERA
Middle Name:KAY
Last Name:BECKORT
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 1:1023 S RILEY DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-6736
Mailing Address - Country:US
Mailing Address - Phone:812-752-3564
Mailing Address - Fax:
Practice Address - Street 1:1350 N TODD DR
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-7755
Practice Address - Country:US
Practice Address - Phone:812-752-5663
Practice Address - Fax:812-752-9853
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003713A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist