Provider Demographics
NPI:1740995885
Name:FLOYD, SHERYL (LMT)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 LAURENCE ELEANOR ST
Mailing Address - Street 2:
Mailing Address - City:STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06378-1938
Mailing Address - Country:US
Mailing Address - Phone:860-961-2503
Mailing Address - Fax:
Practice Address - Street 1:22 BAYVIEW AVE
Practice Address - Street 2:STUDIO 94
Practice Address - City:STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06378
Practice Address - Country:US
Practice Address - Phone:860-326-6815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6458225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT6458OtherCONNECTICUT MASSAGE THERAPIST LICENSE