Provider Demographics
NPI:1356571996
Name:SHEEHAN, AMANDA M (PT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 REGENCY PLACE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695
Mailing Address - Country:US
Mailing Address - Phone:301-934-5336
Mailing Address - Fax:301-934-0498
Practice Address - Street 1:4470 REGENCY PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695
Practice Address - Country:US
Practice Address - Phone:301-934-5336
Practice Address - Fax:301-934-0498
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist