Provider Demographics
NPI:1366747891
Name:GONCALVES, SHERYL KATHLEEN (DPT, PT)
Entity type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:KATHLEEN
Last Name:GONCALVES
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
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Mailing Address - Street 1:8503 BROMLEY CT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-4533
Mailing Address - Country:US
Mailing Address - Phone:571-239-5830
Mailing Address - Fax:
Practice Address - Street 1:11240 WAPLES MILL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6078
Practice Address - Country:US
Practice Address - Phone:703-237-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052050152251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics