Provider Demographics
NPI:1174062004
Name:SHEEHAN, NANCY (COTA//L)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:COTA//L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12234 COOPERS RUN
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-9238
Mailing Address - Country:US
Mailing Address - Phone:440-572-2737
Mailing Address - Fax:
Practice Address - Street 1:12234 COOPERS RUN
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44149-9238
Practice Address - Country:US
Practice Address - Phone:440-572-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-12
Last Update Date:2017-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01752224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant