Provider Demographics
NPI:1285873786
Name:KEWLEY, SHEILA ROSE (MACCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ROSE
Last Name:KEWLEY
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 SAND WEDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-6054
Mailing Address - Country:US
Mailing Address - Phone:407-256-5076
Mailing Address - Fax:407-889-3877
Practice Address - Street 1:578 SAND WEDGE LOOP
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-6054
Practice Address - Country:US
Practice Address - Phone:407-256-5076
Practice Address - Fax:407-889-3877
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2009-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 4498235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist