Individual
DEIDRE ANN SHIMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPY
Contact information
Practice address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 255-4568
(386) 252-3403
Mailing address
1219 DUNN AVE, DAYTONA BEACH, FL 32114-2405
(386) 255-4568
(386) 252-3403
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT14327
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT14327
OCCUPATIONAL THERAPY LICENCE
FL
Enumeration date
11/08/2010
Last updated
11/08/2010
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