Provider Demographics
NPI:1396259800
Name:SHELDRICK, TAYLOR (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:
Last Name:SHELDRICK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 PASEO VERDE PKWY STE 155
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7120
Mailing Address - Country:US
Mailing Address - Phone:702-515-4009
Mailing Address - Fax:
Practice Address - Street 1:2490 PASEO VERDE PKWY STE 155
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7120
Practice Address - Country:US
Practice Address - Phone:702-515-4009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2024-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18023225X00000X
WA61205614225X00000X
NVOT-3573225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist