Provider Demographics
NPI:1740519156
Name:DESPRES, SHEILA RITA (PT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:RITA
Last Name:DESPRES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:RITA
Other - Last Name:AREL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:55 CINEMA BLVD
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3290
Mailing Address - Country:US
Mailing Address - Phone:978-401-3100
Mailing Address - Fax:978-401-3116
Practice Address - Street 1:55 CINEMA BLVD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3290
Practice Address - Country:US
Practice Address - Phone:978-401-3100
Practice Address - Fax:978-401-3116
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist