Provider Demographics
NPI:1962608612
Name:SHEEHAN, MARIANNA STRACHAN (RPT)
Entity type:Individual
Prefix:MS
First Name:MARIANNA
Middle Name:STRACHAN
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2067A KILAKILA DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1226
Mailing Address - Country:US
Mailing Address - Phone:808-778-2888
Mailing Address - Fax:
Practice Address - Street 1:KAPIOLANI EARLY INTERVENTION SERVCIES-CENTRAL PROGRAM
Practice Address - Street 2:99-080 KAUHALE STREET SUITE D-9
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-483-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT2164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist