Organization
ISENBERG PEDIATRIC OCCUPATIONAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLEY ISENBERG HICKMAN OTR/L (OWNER)
(850) 258-6366
Entity
Organization
Contact information
Practice address
2685 JENKS AVE, PANAMA CITY, FL 32405-4351
(850) 258-6366
(850) 522-8022
Mailing address
PO BOX 568, LYNN HAVEN, FL 32444-0568
(850) 258-6366
(850) 522-8022
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT2238
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
810737800
—
FL
05
—
881001000
—
FL
05
—
886362800
—
FL
Enumeration date
08/28/2008
Last updated
08/28/2008
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