Healthcare Provider Details

I. General information

NPI: 1144432618
Provider Name (Legal Business Name): NICOLE SHEAFF OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1F COMMONS DRIVE SUITE 38
LONDONDERRY NH
03053
US

IV. Provider business mailing address

50 BROOKSIDE DRIVE D-4
EXETER NH
03833
US

V. Phone/Fax

Practice location:
  • Phone: 603-437-3330
  • Fax: 603-437-0431
Mailing address:
  • Phone: 603-437-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1865
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: