Provider Demographics
NPI:1851134670
Name:DOWDEN, SHEVELLE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:SHEVELLE
Middle Name:
Last Name:DOWDEN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:SHEVELLE
Other - Middle Name:
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:725 W PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-8799
Mailing Address - Country:US
Mailing Address - Phone:910-565-2011
Mailing Address - Fax:910-695-3010
Practice Address - Street 1:725 W PROSPECT RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-8799
Practice Address - Country:US
Practice Address - Phone:910-565-2011
Practice Address - Fax:910-695-3010
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16418225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist