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Individual

SHELBY TODD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
5042 42ND ST S, ST PETERSBURG, FL 33711-4720
(727) 871-2784
Mailing address
3614 W ROLAND ST, TAMPA, FL 33609-2832
(813) 240-7109

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT22725
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113274700
FL
01
OT22725
FL BOARD OF HEALTH
FL
Enumeration date
02/02/2022
Last updated
02/16/2023
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