Provider Demographics
NPI:1356515613
Name:SHELDON, VENITA DENICE (OTR)
Entity type:Individual
Prefix:
First Name:VENITA
Middle Name:DENICE
Last Name:SHELDON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:VENITA
Other - Middle Name:D
Other - Last Name:SHELDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2849 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642
Mailing Address - Country:US
Mailing Address - Phone:409-983-6659
Mailing Address - Fax:409-983-6408
Practice Address - Street 1:2849 9TH AVE
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642
Practice Address - Country:US
Practice Address - Phone:409-983-6659
Practice Address - Fax:409-983-6408
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112527225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist