Provider Demographics
NPI:1457377558
Name:SHIERS, SHEILA ELIZABETH (OT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:ELIZABETH
Last Name:SHIERS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 908
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38068-0908
Mailing Address - Country:US
Mailing Address - Phone:901-465-1801
Mailing Address - Fax:901-465-1801
Practice Address - Street 1:301 N WEST ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068-1309
Practice Address - Country:US
Practice Address - Phone:901-465-1801
Practice Address - Fax:901-465-1894
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2717225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3656712Medicaid
TN3656712Medicare ID - Type Unspecified