Provider Demographics
NPI:1871817478
Name:SHEPHERD, SHERI LYNN (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:SHERI
Middle Name:LYNN
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2666 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1620
Mailing Address - Country:US
Mailing Address - Phone:937-427-4102
Mailing Address - Fax:
Practice Address - Street 1:2666 LONGWOOD DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-1620
Practice Address - Country:US
Practice Address - Phone:937-427-4102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2914225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist