Individual
MRS. SHELLENE SUE CLEVERDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT-L
Contact information
Practice address
42468 JUNIPER SHORES LANE, DAYTON, MT 59914
(406) 260-5692
(406) 849-6501
Mailing address
PO BOX 200, DAYTON, MT 59914
(406) 260-5692
(406) 849-6501
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
523
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347293
—
MT
01
—
660990
BCBS
MT
Enumeration date
08/31/2006
Last updated
06/06/2016
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