Provider Demographics
NPI:1952013245
Name:DEMOUCHET, SHEILA
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:DEMOUCHET
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 1:2918 MELANCON RD
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-8254
Mailing Address - Country:US
Mailing Address - Phone:337-280-4849
Mailing Address - Fax:
Practice Address - Street 1:2918 MELANCON RD
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-8254
Practice Address - Country:US
Practice Address - Phone:337-280-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9427225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist