Provider Demographics
NPI:1255970737
Name:SHEEHAN, NANCY MICHELLE (LMT, BCTMB)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MICHELLE
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:LMT, BCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 N MAIN ST STE 10
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512-3252
Mailing Address - Country:US
Mailing Address - Phone:609-655-1801
Mailing Address - Fax:
Practice Address - Street 1:60 N MAIN ST STE 10
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3252
Practice Address - Country:US
Practice Address - Phone:609-655-1801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00480000225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist