Provider Demographics
NPI:1306434758
Name:CAULEY, SHELIA ANN
Entity type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:ANN
Last Name:CAULEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHELIA
Other - Middle Name:ANN
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4491 S US HIGHWAY 45
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-7471
Mailing Address - Country:US
Mailing Address - Phone:920-279-7905
Mailing Address - Fax:
Practice Address - Street 1:9305 SHAWNEE TRL
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-5022
Practice Address - Country:US
Practice Address - Phone:614-318-5375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child