Provider Demographics
NPI:1487737045
Name:THOMPSON, SHEILA L (PTA)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:L
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:220 N MAPLE AVE
Mailing Address - Street 2:APT. #7
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2764
Mailing Address - Country:US
Mailing Address - Phone:931-372-8152
Mailing Address - Fax:
Practice Address - Street 1:444 ONE ELEVEN PL
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-4358
Practice Address - Country:US
Practice Address - Phone:931-525-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002311225200000X
TN3358225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant