Provider Demographics
NPI:1760004006
Name:SHERIDAN, HOPE (LMT, MMP)
Entity Type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HOBCAW DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2337
Mailing Address - Country:US
Mailing Address - Phone:803-552-5238
Mailing Address - Fax:
Practice Address - Street 1:103 HOBCAW DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2337
Practice Address - Country:US
Practice Address - Phone:803-552-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-09
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11904225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist