Provider Demographics
NPI:1720136914
Name:SHEOLA, ROSEMARY D
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:D
Last Name:SHEOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 WENDELL RD
Mailing Address - Street 2:
Mailing Address - City:SHUTESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01072-9753
Mailing Address - Country:US
Mailing Address - Phone:413-774-1000
Mailing Address - Fax:
Practice Address - Street 1:215 SHELBURNE RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-9622
Practice Address - Country:US
Practice Address - Phone:413-774-1000
Practice Address - Fax:413-774-1197
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5718OtherLICENSE